ROCHESTER, MN IKES
                                                      CHAPTER MEMBERSHIP FORM
 
You can support IWLA’s community based, commonsense approach to conservation by becoming a member today. Please copy and paste this form into a document app, print, fill it out, and return it to us with your check.
 
Annual Memberships:
___ Individual (1 adult)                                  $71.50
___ Family (2 adults at same address)        $99.00
___ Student (age 18-21 or undergraduate)  $44.00
___ Youth (age 17 and under)                       $20.00
 
Name:        
 
Second Name (Family Membership):
    
Date of Birth (Student or Youth only):

Address: 
    
City:                                                                                    State:                  Zip:

Telephone: (______)  _________ ___________      

E-mail__________        


$ ___________ Total amount enclosed
​(Please make check payable to:  Rochester Chapter IWLA)
   ___________ Today’s date



Mail to:   Rochester Chapter IWLA
                PO Box 431 
                Rochester, MN 55903
 
FOR MORE INFORMATION:
rochestermnikes@gmail.com