NO. __________(to be completed by FSSSHA)
Membership Application
Friends of Sycamore Shoals State Historic Area
OUR PURPOSE: Organize a corporation to support Sycamore Shoals State Historic Area and the affiliated John Landon Carter Historic Mansion by educating the public about the park’s unique qualities through presentation and support of projects related to the mission and the betterment of the park.
Name: 1_________________________ 2.__________________________
For Family Membership
Address: _____________________________________________________
City: _________________________State: _______________ Zip: _______
Phone: ________________________ E-Mail: ________________________
Corporation (if applicable) _______________________________________
Annual Membership:
______Individual $25.00
______Family (2 Min. 16+) $35.00
______Student(16 & over) $15.00
Annual Corporate Membership:
______Contributing $200.00
______Partner $300.00
______Sustaining $500.00
______Benefactor $1000.00
MEMBERSHIP DUES WILL BE TAX DEDUCTIBLE UPON
RECEIPT OF 501C3 STATUS-Retroactive to the date of incorporation.
Mail application and check to:
Friends of Sycamore Shoals State Historic Area
1373 Rittertown Rd. Hampton, TN 37658