Name:

Address:

Email:

Organization (if applicable):

Membership Category: (check one)

Individual $25.00

Organization $50.00

Patron $250.00

Benefactor $500.00

For a tax deductible donation please send a check or money order made payable to Chesapeake Bay Outward Bound earmarked for Friends of Orianda House at 1901 Eagle Drive, Baltimore, MD 21207
Attn. Richard Smith