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Clearwater Conservancy

ANNUAL MEMBERSHIP APPLICATION:

Mail to: Clearwater Conservancy     PO BOX 100    Rapid City, MI 49676

 

Name: _____________________________

Address: ___________________________
                 ___________________________

Phone: _____________________________

Email: _____________________________

 

Amount of Contribution:

_____ Individual $5 or more

_____ Couple $10 or more

_____ Household (family) $15 or more

_____ Life Memberships (couple) $150 or more

_____ “ In Memory of: ________________________” 
$100 or more (One time donation)

_____ Business $25 or more

_____ Business Lifetime Membership $250