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Last Revised:
6-27-2006

© Copyright
2004-2008
by the Crystal Lake
& Watershed
Association and
ATI Consulting

All Rights Reserved.

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Crystal Lake and Watershed Association

 

Crystal Lake &
Watershed Association
P.O. Box 89, Beulah, MI 49617
Phone: (231) 882-4001
FAX: (231) 882-7810
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Membership Form


Please Support Your CLWA

One check may be sent for all of the below, payable to the Crystal Lake & Watershed Association. All dues, gifts, and contributions are fully tax deductible. Please include the information below with your check and mail to:

Crystal Lake & Watershed Association
P.O. Box 89, Beulah, MI 49617

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Membership Dues for the year: _______ (Minimum $35 annually)
Other_______ $500 $250 $100 $70 $35  

2020 Vision Fund:
  Other_______   $1000   $500   $250   $100   $50   $25

Endowment Fund:   In Memory of   In Honor of   On the Occasion of   Unspecified
  Amount: ______ (No amount will be mentioned.)
Name, Event, or Occasion ___________________________________
Please include name and address if you wish an acknowledgment of your gift.

Total Enclosed ___________           (Please print all entries on this form)

Member Name(s) ________________________________________________
Summer Address

_____________________________
Street Address/Post Office Box

_____________________________
City, State, Zip Code

_____________________________
Area Code, Phone #
Mailing (Winter) Address

_____________________________
Street Address/Post Office Box

_____________________________
City, State, Zip Code

_____________________________
Area Code, Phone #


Email Address (optional) _________________________________

Check this box if this is a Business Membership.

I do not receive mail at my summer address.

Yes, I would like to receive a pre-paid subscription to the The Michigan Riparian magazine.