Membership Form

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0 height="100%"><tr> <td valign="top" width=200 BGCOLOR="#006633" TEXT="#F7F7FF"> <div> <IMG SRC="0a69e480.png" border=0 width="158" height="328" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <div> © 2005-2008 </div> <div> Vivian Pennington-Hopkins</div> <div> All rights reserved</div> <div> <FONT SIZE="2" COLOR="#000000" FACE="Arial" > </FONT><FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT>  <A HREF="index.htm" TARGET="_top" TITLE="Historic Gold Hill"><U>home</U></A></div> <div> <A HREF="id15.htm" TARGET="_top" TITLE="Historic Gold Hill and Mines Foundation,"><U>Historic Gold Hill and Mines Foundation, Inc.</U></A>   |   <A HREF="id16.htm" TARGET="_top" TITLE="Current Board of Directors"><U>Current Board of Directors</U></A>   |   <A HREF="id17.htm" TARGET="_top" TITLE="Current Officers"><U>Current Officers</U></A>   |   Membership Form</div> <bR> <div>  </div> </td> <td valign="top" BGCOLOR="#FFFBF0" TEXT="#080000"> <div> <FONT SIZE="5" COLOR="#000000" FACE="Arial" ><B>Historic Gold Hill</B></FONT> <FONT SIZE="1" COLOR="#3366FF" FACE="Arial" > </FONT>   |   <FONT SIZE="1" COLOR="#FFCC00" FACE="Arial" >  <A HREF="index.htm" TARGET="_top" TITLE="Historic Gold Hill"><U>home</U></A></FONT></div> <div> <A HREF="id15.htm" TARGET="_top" TITLE="Historic Gold Hill and Mines Foundation,"><U>Historic Gold Hill and Mines Foundation, Inc.</U></A>   |   <A HREF="id16.htm" TARGET="_top" TITLE="Current Board of Directors"><U>Current Board of Directors</U></A>   |   <A HREF="id17.htm" TARGET="_top" TITLE="Current Officers"><U>Current Officers</U></A>   |   Membership Form</div> <div> Membership Form</div> <div> <A HREF="id3.htm" TARGET="_top" TITLE="About Us/Contact Us"><U>Back to </U></A><FONT SIZE="3" COLOR="#000000" FACE="Arial" ><A HREF="id3.htm" TARGET="_top" TITLE="About Us/Contact Us"><U><I><B>About US</B></I></U></A></FONT></div> <bR> <bR> <div> <I><B> Membership Information                                                         </B></I></div> <div> <I><B>Membership is as follows:  Your generous support is appreciated.</B></I></div> <bR> <div> <I><B>Name________________________________________________               </B></I></div> <bR> <div> <I><B>Mailing Address________________________________________</B></I></div> <bR> <div> <I><B>City____________________________State____  Zip__________                   </B></I></div> <bR> <div> <I><B>__Lifetime Member....$1,000 and up          __Business.............$100 and up</B></I></div> <div> <I><B>__Corporate Patron..... .$500 and up         __Sustaining..........$50 to $124</B></I></div> <div> <I><B>__Miner ......................$250 to $499              __Family............................$35</B></I></div> <div> <I><B>__Prospector................$125 to $249           __Individual.......................$20</B></I></div> <bR> <div> <I><B>__I am interested in joining the Historic Gold Hill and Mines Foundation, and actively participating  in Foundation activities.</B></I></div> <bR> <div> <I><B>__I am interested in including Historic Gold Hill and Mines Foundation in my will.  Please send me information about the bequest of real estate, stocks, securities, antiques, etc...</B></I></div> <bR> <div> <I><B>__I am interested in knowing more about the foundation. </B></I></div> <bR> <div> <I><B>ALL DONATIONS ARE TAX DEDUCTIBLE TO THE EXTENT OF THE LAW</B></I></div> <div> <I><B>The Education Committee publishes a quarterly newsletter 'THE GOLD HILL MINER'. Subscriptions are free to members. Contact us to become a member call 704.279.7897 or 704.267.9439</B></I></div> <bR> <div> <I><B> Print and mail this form to:</B></I></div> <bR> <div> <I><B>Historic Gold Hill and Mines Foundation, Inc.</B></I></div> <div> <I><B>PO Box 206 </B></I></div> <div> <I><B>Gold Hill, NC 28071</B></I></div> <bR> <div> <I><B> </B></I></div> </td> </tr></table></body>