MEMBERSHIP FORM

Please print, complete, and mail with payment or use the links

below to pay online using a secure server.

NAME________________________________________________________________________

AFFILIATION__________________________________________________________________

ADDRESS_____________________________________________________________________

CITY, STATE, ZIP_______________________________________________________________

PHONE: ______________________________________________________________________

FAX:_________________________________________________________________________

E-MAIL:_________________________________________________________________________

Membership Category	Circle or Click Your Payment
One-Year Individual Forum Membership [Benefits of Membership]	$  35.00
One-Year Student Membership	$  15.00
One-Year Corporate Membership	$100.00
TOTAL ENCLOSED or           Click Here to Review Total	$______

Please make checks out to the New York State Wetlands Forum, Inc.  EIN# 14-1723859. Mail checks and this form to New York State Wetlands Forum, Inc., P.O. Box 1351, Latham, NY  12110-1351, or fax to 518-783-1258.

 

Home | Membership | Events/Programs | News and Announcements | Calendar | Related Links | Search | Contact Us | Site Map