Seth Peterson
Cottage Conservancy, Inc.
Membership
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| Item |
Choices |
Number |
Unit Price |
Subtotal |
Total |
| Individual membership |
New |
Renewal |
Gift |
|
$15.00 |
|
|
| Household membership |
New |
Renewal |
Gift |
|
$25.00 |
|
|
| Friend Membership |
New |
Renewal |
Gift |
|
$50.00 |
|
|
| Preserver membership |
New |
Renewal |
Gift |
|
$100.00 |
|
|
| Life membership |
New |
Renewal |
Gift |
|
$250.00 |
|
|
|
Membership subtotal: |
|
| Name |
|
| Address |
|
| |
| City/State/Zip |
|
| Telephone |
|
| Email |
|
Make checks payable and mail form to:
Seth Peterson Cottage Conservancy, Inc.
c/o Wegner LLP
123 2nd Street
P.O. Box 150
Baraboo, WI 53913
Thank you!
|
