Outagamie Conservation Club

YOU CAN BECOME A MEMBER OF THE OUTAGAMIE CONSERVATION CLUB BY FILLING THIS MEMBERSHIP OUT. MAIL THIS MEMBERSHIP AND A CHECK FOR 30.OO DOLLARS TO THE CLUBS ADDRESS. WE WILL MAKE YOU OUT A MEMBERSHIP CARD AND MAIL YOU YOUR MEMBERSHIP STUB. THE MEMBERSHIP RUNS JAN.1 THRU, DEC 31 OF THE CALENDAR YEAR

Name: _______________________________________  Spouse:_________________

Address:______________________________________________________________

City:______________________________________ State:_________ Zip:__________

Date:_______________ Phone: (           )____________________________________

Email:______________________ @________________________________________

Interest:     check all that apply   

Annual membership is $30.00 a family                                                                       

Lifetime membership is $275.00

Please print this form, then mail completed application with payment to: