Brunswick Environmental Action Team
(BEAT)
Membership Form (Individual, Family, Student, Gift)
(Membership fees have not yet started. To become a member, complete
this form and send to Tom Goodwin, BEAT Treasurer, at or to 1080 Sea Bourne Way, Sunset Beach, NC, 28468)
Before completing the membership application, be sure to read BEAT's mission statement, vision statement, and core values (available on our website - www.bcbeat.org)? Do you support these statements?
_____ Yes - then please do send in the form and we look forward to having you as a member
_____ No - then we appreciate your desire for civic involvement, but BEAT does not seem to be a good fit for your interests
Name:
Address:
Phone:
E-mail:
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Membership Type:
____
____ (please list all names above)
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Individual
Family
Student
At what school?
Have you received this membership as a gift? _____ Yes _____ No
Primary Areas
of Environmental
Interest (check
as many as apply):
___ Clean, renewable energy
___ Ecosystem/wildlife protection
___ Environmental Injustice
___ Land conservation/
management
___ Nuclear safety
___ Seismic blasting/offshore
drilling
___ Water quality/storm water runoff
___ Climate change/global warming
___ Dredging of waterways
___ Industrial agriculture/hog farming
___ Landfills/recycling/plastics
___ Pollution (air, marine, solid waste, water)
___ Terminal groins
___ Other (specify) _____________
Please check any standing committees in which you might be interested in serving; check all that apply)
_____ Finance/Fund-raising
_____ Media
_____ Special Events
Please return this completed form to Tom Goodwin, BEAT Treasurer, at or to 1080 Sea Bourne Way, Sunset Beach, NC, 28468.