_____ $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
Mail to:
Club Coordinator
Cosmopolitan Club
307 East John St.
Champaign, IL 61820
Donations are tax-deductible according to law.
If you have any questions concerning donations to the Cosmopolitan Club, please call the Club Coordinator 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 ________________________________________________________
Address
______________________________________________________
City
_______________________________
State ________________________ Zip Code
________________
Country ___________________________________
Telephone __________________________
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