Friends of Rocheport

P.O. Box  122, Rocheport, MO  65279


2017 Friends of Rocheport Membership Form

Name:   __________________________________________________________________


Address:  _________________________________________________________________


City/State/Zip:  ___________________________________________________________


Phone:  __________________________________________________________________


E-mail:  ___________________________________________________________________


Membership Dues:  ($20 per household or business)  $________________ enclosed


Special Gift:  $ ___________________


Please make your check payable to "Friends of Rocheport Society"


Mail to:     Friends of Rocheport Society

                P.O. Box 122

               Rocheport, MO  65279


The Friends of Rocheport Society is a 501(c)(3) organization.  Contributions are tax deductible.