Gift Membership Application

Please print out this page and mail it in with your check.

_____Please find enclosed my tax-deductible donation.

____I want to give a Gift Membership ($25 / year USA, $40/ year, other countries)

Donor Name____________________________________________________

Address___________________________________________________

City______________________________State_________Zip_________

Phone______________________Email__________________________

Recipient Name:____________________________________________________

Address___________________________________________________

City______________________________State_________Zip or Mail Code_________

Gift Message:______________________________________________________________________________

____________________________________________________________________________________________

▢ Donor wishes to remain anonymous

Please make check or money order payable to:

Opossum Society of the United States (O.S.U.S.)
P.O. Box 16724
Irvine, CA 92623