Eldorado Main Street Membership Form

To become a Member/Volunteer, print out, fill out, and return this form to:

Main Street Eldorado, Inc. , 1604 Locust St., Eldorado, IL.

Mailing address: Main Street Eldorado, PO Box 435, Eldorado. IL, 62930

	Individual	Business/Organization
Basic	o $ 20.00	o $ 50.00
Silver	o $ 25.00	o $ 250.00
Gold	o $ 50.00	o $ 500.00
Platinum	o $100.00	o $1000.00
Diamond	o $ 500.00	o $5000.00

o I would like to serve on a committee.

o I would like to volunteer, but I do not wish to serve on a committee.

o I would like to make a one time donation.

Name: _________________________________________________

Address: _______________________________________________

Telephone: _____________________