ARSIRN SUPPORT FORM 2013

We have 3 levels of annual support. Each includes a $35 contribution to the Ayn Rand Center for Individual Rights (ARC) for which you receive their monthly report, Impact. {Note: ARSIRN is a Florida nonprofit corporation, but not an IRS 501c3. For donations to ARC to be tax deductible a separate check to the ARC is required.}

___ Supporter: $75 ($125 couples) includes ARC donation, attendance at suppers and all other non-fee activities, 20% discount on all books at any Books-A-Million store and a 99% pure copper medallion from a D'Anconia mine.

___ Sustaining: $175 ($225 couples) includes all Supporter privileges, free attendance at ARSIRN-sponsored Renaissance Academy events, a copy of the next issue of the Quarterly The Objective Standard for yourself or a designee.

___ Benefactor: $275 ($350 couples) includes all Supporter and Sustaining privileges plus invitations to private, limited-seating, dutch-treat luncheons with Distinguished Scholars speakers.

____ Student Member: $15 or volunteer to assist at ARSIRN functions as needed. plus contribution to ARI/ARC
I attend (name of school): _____________________________________

Send IMPACT, ARI's monthly newsletter by _____ email ____snail mail

Fill in, fax to 239.263.4955 or mail to:
P.O. Box 7173, Naples, FL 34101-7173

Date Submitted: ______________________________

First Name: _____________________________________________

Nickname : _____________________________________________

Last Name: _____________________________________________

Street Address1: _____________________________________________

Street Address2: _____________________________________________

City, State, ZIP: ____________________________________________

Email: ______________________________

Day/Night Phone: _________________ /_________________________