Sustainer Agreement
please print and mail to:
1000 Friends of Oregon, 534 SW Third Suite 300, Portland, OR 97204

Name__________________________________________________

Address________________________________________________

City__________________ State________ Zip_________________

E-mail_______________________Phone_____________________

Yes! I want to join the Sustainer Circle with monthly gifts of $________________($10 suggested minimum - just 33¢ a day!)

_ Please deduct my gifts from my bank account.
I have enclosed one of the following:
_ A voided check (for checking accounts)
_ A deposit slip (for savings accounts)

_ I wish to charge my monthly gifts to my credit card.
__ Visa __ Mastercard #_______________________________
Expiration date_______________________________________

I understand that 1000 Friends of Oregon will charge my account on or near the 15th day of each month, starting the month after I sign this agreement. I also understand that this authority is to remain in full force and effect until 1000 Friends of Oregon has received written notification from me (or either of us) of its termination in such time and in such manner as to afford 1000 Friends of Oregon and the financial institution a reasonable opportunity to act on it.

Signature(s)________________________________________

Date______________________________________________

1000 Friends of Oregon - Promoting land use planning for an Oregon we're proud to call home: livable communities, productive farm and forest lands, protected scenic and natural areas. For more information, please contact Kristie Perry at (503) 497-1000 or e-mail kristie@friends.org.

(Please mail to 1000 Friends of Oregon, 534 SW Third Ave., Suite 300, Portland, OR 97204)

THANK YOU!

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