Membership

_$25 (MEMBER)
_$120 or $10/month (SUPPORTER)
_$150 to $499 (SUSTAINER)
_$500 or more (PATRON)
Name___________________________
Organizational affiliation (if any) _______________________________
Address_________________________
City_________ State_____Zip_______
Phone (H)________________ (W)________________

Please print this form and send it to:
Topeka Center for Peace and Justice
1248 SW Buchanan Topeka, KS 66604-1263