MIME-Version: 1.0 Content-Location: file:///C:/9E84CAAD/applicationform.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" INDIAN LAKE WATERSHED PROJECT MEMBERSHIP APPLICATION

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INDIAN LAKE WATERSHED PROJECT MEMBERSHIP APPLICATION

YES!  I support sound watershed management.  I want to help co= ntrol non point source pollution and wish to join as an Indian Lake Watershed Member!  I understan= d my dues are a tax deductible donation to the Indian Lake Watershed Project and= may be used for the implementation of pollution control programs, endowment building and to offset overhead and administrative costs.

 

Please Print

NAME:_________________= ____________________________        &= nbsp;          Annual Dues Only     $      10.00=

   = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;              &= nbsp;           &nbs= p;            &= nbsp;  Endowment        =          $________

ADDRESS:______________= ____________________________        &= nbsp;         Education              =       $________

   = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;     Scholarship                 $________

   = ;                __________________________________________            =     General        &= nbsp;           &nbs= p;           =  $________

 

   = ;                _____________________________, _____   ______            =   Total Enclosed         =   $________

   = ;            &n= bsp;        (City)        &= nbsp;           &nbs= p;            &= nbsp;               =   (St)     &n= bsp;   Zip

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Make Your Check Payable to “ILWP” and mail to 324 Co. Rd. 11

        &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;  Bellefontaine, Ohio 43311<= /st1:PostalCode>        =                  =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =