Passages Sustainable Food and Farming Systems - PASA
Passages Sustainable Food and Farming Systems - PASA
Passages Sustainable Food and Farming Systems - PASA
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Membership<br />
& Contribution Form<br />
Please clip this application <strong>and</strong> return with payment to:<br />
<strong>PASA</strong> Membership, PO Box 419, Millheim, PA 16854<br />
or join online at pasafarming.org<br />
Join <strong>PASA</strong> & Become Part of the Good <strong>Food</strong> Neighborhood <br />
— a community of people who care about local food & businesses<br />
FULL <strong>PASA</strong> MEMBERSHIP<br />
FULL <strong>PASA</strong> MEMBERSHIP BENEFITS<br />
• A subscription to our bimonthly, <strong>Passages</strong> newsletter<br />
• Discounted admission to our annual conference, field day & intensive<br />
learning programs<br />
• Invitations to other special events, such as membership potlucks &<br />
Harvest Celebration dinners<br />
• Event promotion via our website & newsletter<br />
• Free classified ad <strong>and</strong> discounted display advertising in <strong>Passages</strong><br />
• Voting privileges for board of director elections & bylaws<br />
• Membership networking opportunities regionally & via <strong>PASA</strong> discussion<br />
groups<br />
• Discounts on Buy Fresh Buy Local® partner fees (coordinated through<br />
local chapters)<br />
• Assistance with <strong>Food</strong> Alliance sustainable certification<br />
• The satisfaction of knowing that you are helping to sustain<br />
agriculture in your region<br />
FULL <strong>PASA</strong> MEMBERSHIP OPTIONS<br />
Individual $45<br />
Individual — Two Year RENEWAL Membership (Save $10)<br />
Note: Two year membership options are for current members RENEWING only! $80<br />
Family/Farm Please complete field below $70<br />
Family/Farm — Two Year RENEWAL Membership (Save $10)<br />
Note: Two year membership options are for current members RENEWING only! $130<br />
Sustaining Lifetime Member<br />
Please complete the Family/Farm Membership field below $1,400<br />
Nonprofit Please complete field below $100<br />
Business Please complete field below $150<br />
Business Patron<br />
<strong>PASA</strong> will contact you for the 12 names of those to receive individual<br />
membership benefits. $500<br />
Permanent Business Partner<br />
Please complete the Nonprofit/Business Membership field below $3,000<br />
Family/Farm or Sustaining Lifetime Membership<br />
Please list all names for this Family/Farm membership. You may include children between the<br />
ages of 14–22, <strong>and</strong> also multiple generations directly involved in the farm.<br />
MEMBERSHIP CONTACT INFORMATION<br />
Please list the main contact for the membership<br />
Name<br />
Nonprofit / Business / Permanent Business Partner Membership<br />
Please list up to two additional people associated with your business to receive individual<br />
membership privileges.<br />
Company/Farm<br />
Address<br />
City<br />
State<br />
ZIP+4<br />
County<br />
Home Phone<br />
E-mail<br />
Web Address<br />
Work Phone<br />
DONATIONS<br />
Consider lending extra support to these two <strong>PASA</strong> funds.<br />
The Annual Fund supports <strong>PASA</strong>’s basic operations.<br />
$<br />
Are you farming: NO YES — how many acres:<br />
How did you learn about <strong>PASA</strong>:<br />
The Arias M. Brownback Scholarship Fund helps those<br />
wishing to learn about sustainable agriculture attend the<br />
annual conference regardless of financial position.<br />
$<br />
PAYMENT<br />
<strong>PASA</strong><br />
PO Box 419 • Millheim, PA 16854<br />
www.pasafarming.org<br />
Total amount due<br />
$<br />
Check Payable to <strong>PASA</strong><br />
Credit Card Complete at<br />
right<br />
35<br />
Card No.<br />
VISA MasterCard Discover<br />
Cardholder Name<br />
Signature<br />
Exp. Date<br />
<strong>PASA</strong> is a registered 501 (C) 3 organization <strong>and</strong> contributions are tax exempt. The official registration <strong>and</strong> financial information<br />
of Pennsylvania Association for <strong>Sustainable</strong> Agriculture may be obtained from the Pennsylvania Department of<br />
State by calling toll-free, within Pennsylvania, 800-732-0999. Registration does not imply endorsement.
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