WDHA Membership Form

Please print out and mail this form to the address below. Your personal information is 100% guaranteed safe, we will NEVER pass this information on to anyone or anything not associated with this organization. Please write legibly.



First Name ___________________________________________ MI _________

Last Name __________________________________________________________

Business or Organization Name _________________________________________

Address ____________________________________________________________

City ________________________________________________ State __________

Zip ________________________________

County _____________________________________

Telephone __________________________________________________________

Email ______________________________________________________________

Please check one:

____ Regular annual membership (with email) - $10

____ Regular annual membership (without email) - $15

____ Family annual membership (with email) - $20

____ Family annual membership (without email) - $25

____ Contributing annual membership - $50 and up*


Additional contribution _____________


Total amount submitted _____________

* All members contributing $50 or more will receive a free copy of Aldo Leopold's classic book on wildlife conservation A Sand County Almanac.

Want to do more? We could use assistance in accounting, legal, marketing, web programming, graphic design and other areas. Please email us for details.


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WDHA
PO Box 255
Roberts WI 54023

©2002 WDHA