SFFM Institute Membership Form

Individual Membership Levels with Premiums

$35 Individual ($35 tax-deductible) -- FRESHnews newsletter, window decal
$60 Family ($60 tax-deductible) -- the above, plus NM Wildflower Mix Seed Packet
$100 Planter ($80 tax-deductible) -- the above, plus Farmers’ Market Tote Bag
$250 Grower ($212 tax-deductible) -- the above, plus Farmers’ Market Apron
$500 Cultivator ($442 tax-deductible) -- + $20 gift certificate to the Market’s Mercado
$1,000 Harvester ($912 tax-deductible) -- + Market’s "Best of the Season" Basket ($30 value)
$2,500 Protector ($2162 tax-deductible) -- + 2 VIP tickets to Annual Event
$5,000 or more Angel ($2162 tax-deductible) -- + permanent recognition in the new building

Business Membership Levels with Premiums

$250 Business Member (same as above) -- 'Grower' level premiums above, listing in the newsletter
$500 Business Sponsor -- 'Cultivator' level premiums, more prominent listing in newsletter
$1,000 Business Harvester -- 'Harvester' level premiums, plus listing on all Institute communications
$2,500 Business Protector -- the above, plus 2 VIP tickets to annual event
$5,000 or more Business Angel -- the above, plus permanent recognition in new building and an opportunity to have a booth at the Market.

NAME________________________________________________________________

ADDRESS______________________________________________________________

CITY________________________________ST__________________ZIP__________

EMAIL___________________________________PH___________________________

MEMBERSHIP LEVEL AMT:___________________*
*If you live out of town and can't pick up the merchandise at the Market, please add $6.95 for shipping.

___I don't need the premiums. Please give me the full tax-deduction.

___Here's an additional contribution of $_________ for: (check one) ___operating ___capital campaign

TOTAL ENCLOSED: $_______________

___Enclosed is my check / Please bill my ___VISA ___MasterCard or ___American Express

CREDIT CARD #_________________________________EXPIRATION___________

NAME ON CARD, IF DIFFERENT FROM ABOVE:____________________________

Please print this form, fill it out and mail to:

Santa Fe Farmers' Market Institute

607 Cerrillos Road, Suite F.

Santa Fe, NM 87505

(Ph: 505-983-7726; sffminstitute@yahoo.com)