Please print this form and mail to Water for Life,
or you can email us for more information
(don't forget to add your name address and phone #)

___ Join Water for Life, Inc.
___ I would like to make an additional gift to Water for Life, Inc.
___ I would like to give an additional gift to Water for Life Foundation.
___ Please contact me regarding making a gift of stock, life insurance or real estate.
___ Please contact me regarding leaving a gift through my will.
___ Sign me up for the Water for Life e-news mailing list (free to members)

I would like to contribute $__________.

Please list my membership in the category checked below:

__ Landowner
__1,000 plus irrigated acres ……….$500
__ 500 to 1,000 irrigated acres………250
__ 250 to 500 irrigated acres ………..125
__ 100 to 250 irrigated acres………… 75
__ Under 100 irrigated acres …………50
__ Agriculture Organization - statewide, regional or county organizations…..$1,000
__ Sponsoring Member - businesses that depend on irrigated agriculture ……$100
__ Associate Member – for anyone with ties to agriculture in Oregon ………. $50

Title:___________ First Name: __________________ Last Name: ____________________

Business:_________________________________________________________________

Address: _________________________________________________________________

City: ___________________ State:________________   Zip Code:____________________

Phone Number: _______________Fax_______________E-mail Address:________________

Make checks payable to: Water for Life Inc.