Online Version 1995

After having read the Ten Key Values and mission of the Nebraska Green Party, please print, complete, cut, and then mail the following form to the address at bottom of page.

[ ] Yes, I have read and am in overall agreement with the mission and values of the Nebraska Green Party. Please enroll me, notify me of meetings, sign me up for announcements and mail me Green Focus, the NGP newsletter.
Contribution  [ ] $25 Basic  [ ] $15 Students/Low Income [ ]$35 [ ] $50 [ ] Other $_____
Name____________________________________  Tele (H)___________ (W)___________
Address__________________________________ Email_____________
City____________ State______ Zip____________ Comments:
Date___________

Our finances are very limited, therefore donations are gratefully accepted as well. Thank you.

Please make checks payable to:

The Nebraska Green Party
P.O. Box 85442
Lincoln, NE 68501-5442

*Note: Contributions are not tax deductible.  Contributions are also not manatory for membership.  We will also accept membership forms without financial contributions.