Yes, I’d like to become a friend of the Dauphin Island Sea Lab!

 

Please check one:

Basic Levels: ___Student($30)     ___Individual($50)          ___Family($100)

 

Advanced Levels:  ____Seahorse($250)  _____Skate ($500) ______ Starfish ($1000) _____School of Fish($2500)           

 

______/_____/_______ Today’s date

 

 

______________________________________________

Name

 

______________________________________________

Address

 

______________________________________________

City, State, Zip

 

______________________________________________

Phone number

 

______________________________________________

Email Address

 

 

# ____________________________Exp. Date_________ Credit Card Information, Visa, M/C, Am. Ex., Disc.

 

Please Consider An Additional Donation:$_____________

 

Please print out this form and mail to:

Please make check payable to: The Dauphin Island Sea Lab Foundation (DISLF) P.O. Box 82151 Mobile, AL 36689-2151