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_____ $100 and over _____ $50-99 _____ $21-49 _____ $20 and under _____ $20 non-student membership (annual) _____ $10 student membership (annual) Please make your check payable to: THE COSMOPOLITAN CLUB Donations are tax- Mail to: 307 East John St., Champaign, IL 61820 deductible according to law. If you have any questions concerning donations to the Cosmopolitan Club, please call the Executive Director at (217) 367-3079 (Tuesday mornings, Thursday and Friday afternoons). WE APPRECIATE YOUR SUPPORT and CONTINUING INTEREST in the COSMOPOLITAN CLUB at the UNIVERSITY OF ILLINOIS at URBANA-CHAMPAIGN. Name ________________________________________________________ Telephone _________________________________ Address ______________________________________________________ City ______________________________________ State ________________________ Zip Code _____________________ Country ___________________________________ |