IDAHO TROUT UNLIMITED
P.O. BOX 4643
KETCHUM, IDAHO 83340

__ Yes! I want to support Idaho Trout Unlimited by contributing $1000 annually for three years. I understand my contribution entitles me to a Family Membership package with TU for three years and a limited edition print of Ed Totten's specially commissioned Clark Fork Commemorative print. Joint Contributions are welcome!

__ I cannot contribute $1000 at this time, but I am interested in making a donation of $ _________. I realize this donation does not include a print of Clark Fork Commemorative by Ed Totten.

__ I cannot make a financial contribution at this time, but would like to donate office furniture, equipment, and/or materials. I understand this contribution qualifies for credit with the IRS as a donation to a non-profit organization.

Payment Method:

___ American Express
___ Visa
___ MasterCard
___ Discover
___ Diners Club
___ Check Enclosed

Name________________________________

Address______________________________

____________________________________

E-Mail_______________________________

Account Number______________________

Expiration Date_______________________

Signature____________________________