Donation Form

Donation Amount
I’m a Midland Recycler, too, and will help build the future of Midland Recyclers with a tax-deductible donation as indicated below.

[ ] $25 Recycler
[ ] $50 Green Recycler
[ ] $100 Gold Recycler
[ ]$200 Gold to Go
Green Recycler

[ ] I am sending an additional $10 to have my name/family name(s) displayed on the recycling truck.
____________________________________________________________(10-35 characters)

Member Details
For our records, please provide the following information.  At no time, will your information be sold or made available to third-parties or used for purposes other than notification of Midland Recyclers programs and events.

Name:_____________________________   Address:___________________________
City/State:__________________________   Zip:_______________________________

Notification Preferences
Please indicate your preference for receiving notifications about Midland Recyclers programs and events.

[  ] Email (the greenest and most cost-effective choice)
[  ] US Mail
[  ] I do not wish to receive information

Thank you for your support!
Please send this form along with your donation in the form of a check or money order, made payable to Midland Recyclers via U.S. Mail or drop it off to us at:

Midland Recyclers
4305 East Ashman St.
Midland, MI 48642