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WildernessProtection - New Mexico Wilderness Alliance

WildernessProtection - New Mexico Wilderness Alliance

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NMWA WILDERNESSCONFERENCERegistration Formorderform<strong>New</strong> <strong>Mexico</strong> <strong>Wilderness</strong> <strong>Alliance</strong>P.O. Box 25464, Albuquerque, NM 87125NMWA NEVER SHARES YOURINFORMATION WITH ANYONE!!!(including Homeland Security)Name _______________________________________________________Phone _______________________________________________________Street ________________________________________________________E-mail________________________________________________________City, State, Zip ___________________________________________________ Item Description Color Qty CostTotalMerchandise Total<strong>New</strong> <strong>Mexico</strong> WILD! design & art direction by:let my imaginationbecome your empowerment.Joe Adair - 505.319-3754 • eye4design@earthlink.net£ Enclosed is my check payable to <strong>New</strong> <strong>Mexico</strong> <strong>Wilderness</strong> <strong>Alliance</strong> Please charge my £ Visa or £ MastercardCard# __________________________________________Expiration Date: _______________Signature: ___________________________________YES! I want to be a member of the <strong>New</strong> <strong>Mexico</strong> <strong>Wilderness</strong> <strong>Alliance</strong>!!! My contribution will gotowards the continued protection and wilderness designation of <strong>New</strong> <strong>Mexico</strong>’s natural heritage.q$25 – Individual q$100 – Contributing qOther $__________q$30 – Family q$250 – Lifetimeq$50 – Supporting q$10 – Student/SeniorName _______________________________Phone_______________________________Street ______________________________E-mail_______________________________City, State, Zip _________________________________________________________________£ Enclosed is my check payable to <strong>New</strong> <strong>Mexico</strong> <strong>Wilderness</strong> <strong>Alliance</strong> Please charge my £ Visa or £ MastercardCard# __________________________________________Expiration Date: _______________Signature: ___________________________________Join <strong>New</strong> <strong>Mexico</strong> <strong>Wilderness</strong> <strong>Alliance</strong>Today! You’ll not only help preserve<strong>New</strong> <strong>Mexico</strong>’s Wild Places for your ownenjoyment… but you’ll help insure thatfuture generations may enjoy them too.<strong>New</strong> <strong>Mexico</strong> WILD!Mail yourTax DeductibleDonations to:<strong>New</strong> <strong>Mexico</strong><strong>Wilderness</strong> <strong>Alliance</strong>PO Box 25464Albuquerque, NM87125-0464Questions?505/843-8696Contact info.The Honorable Jeff BingamanU.S. Senate703 Hart Senate Office BuildingWashington, D.C. 20510Phone: 202 224-5521Fax: 202 224-2852The Honorable Pete DomeniciU.S. Senate328 Hart Senate Office BuildingWashington, D.C. 20510ABQ. Phone: 505 347-6781ABQ. Fax: 505 346-6720The Honorable Tom UdallU.S. House of Representatives502 Cannon House Office BuildingWashington, D.C. 20515Phone: 202 225-6190Fax: 202 226-1331The Honorable Heather WilsonU.S. House of Representatives318 Cannon House Office BuildingWashington, D.C. 20515ABQ. Phone: 505 346-6781ABQ. Fax: 505 346-6723Page 19

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