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Secure America’s Future Economy (SAFE)

214 N. Spring Valley Road

Wilmington, DE 19807

Date: ___________

I agree with the SAFE agenda and would like to join the organization and/or support your efforts.  Enclosed is my check made out to “SAFE,” in the total amount of $ _______, to be applied as follows:

________ for annual dues at the rate of $10 per year     

                (prepayments allowed)

________ as a contribution (SAFE is a Section 501(c)(3)

                non-profit organization)

Name _______________________________________

Street Address ________________________________

City _____________ State _____ Zip _____________

Here is how I would like to participate in SAFE (check the item or items that apply).

 [   ] Please put me on the mailing list for your quarterly     

          newsletter.

[   ] Please send me periodic e-mail alerts.  My e-mail

        address is  __________________ .

[   ] I would like to participate in your meetings and other activities; 

       please have one of the directors call me.

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