P.O.Box 433 / 410-d Dallas Street
Talihina, OK 74571
918-567-2023
Email: manager@talihinamainstreet.org

DATE:

NAME:

BUSINESS NAME:
(if applicable)

ADDRESS:

CITY/ST/ZIP:

EMAIL:

PHONE:

PLEASE CHOOSE ANY OF THE FOLLOWING:

• I would like to pledge volunteer time toward projects? YES/NO
  
  
• I would like to serve on this committee (please circle):
  1) ORGANIZATION   2) PROMOTION   3) DESIGN   4) ECONOMIC RESTRUCTURING
  
  
• I would specifically like to:
  
  
  
  
• I have special talents and skills in these areas:
  
  
  
  
• I would like to pledge $__________ per year for ____ years to support Talihina Main Street.
  
  
  

Your membership and support is appreciated with or without pledges of time or service. We are happy to have you on board.

Welcome to Talihina Main Street.