The Graduate Herb Garden
Membership Form

Print this form

Contributions in various increments are described below

Yes, I want to support the Graduate Herb Garden of Southwest Acupuncture College. Enclosed please find the corresponding donation for my support.

I am a Life Supporter of the goals of Southwest Acupuncture College Graduate Herb Garden. Please find a check for $300.00. I will be acknowledged with my name on an individual plaque ded- icated to this concept. The plaque will be placed in front of a particular genus of plant.

I am a Patron of the goals of Southwest Acupuncture College Graduate Herb Garden. Please find a check for $200.00. I will be acknowledged on a group plaque as a graduate dedicated to this concept.

I am a Supporter of the goals of Southwest Acupuncture College Graduate Herb Garden. Please find a check for $100.00. I will be acknowledged as a supporter by having my name listed in a permanent Herbal Support Registry Book.

I am a Friend of Southwest Acupuncture College Graduate Herb Garden. Please find a check for $50.00, which is what I can contribute at this time. I will have my name published along with all of the other contributor categories when the college catalog is published every three years.

Name
Address
City
State Zip
Phone
Email
Office Address
City
State Zip
Work Phone

Check off the campus of your choice for the donation:

Albuquerque Santa Fe Boulder

Please print this form and mail it with your check to:

Southwest Acupuncture College
1622 Galisteo Street
Santa Fe, NM 87505

Thank you for your generous patronage!