New
?___ Renewal? ___ New address?___ If this member does not wish to receive our
publications check here _____
WBH Membership Application
17 E. 3rd St. • PO Box 240 • Clintonville, WI 54929 • (715) 823-4670 Fax (715) 823-1385 e-mail: wbh@frontiernet.net internet: www.wbhassoc.com
MEMBERSHIP APPLICATION
Name __________________________________________________________ (Please Print) First Middle Initial Last
Street __________________________________________________________
City_______________________________State_________Zip ____________
Phone_(________)___________-_____________County ________________
E-mail address __________________________________________________
Birth Date mm/dd/yy ___ ___ / ___ ___ / ___ ___ (Optional) For Statistics Only
Member #
New
?___ Renewal? ___ New address?___ If this member does not wish to receive our
publications check here _____
WBH Memberships...
Individual 1 Year 20.00 $ ___________ Individual 3 Year 50.00 $ ___________ Individual 6 Year 100.00 $ ___________ Individual Lifetime 500.00** $ ___________
**Payable in 4 consecutive quarterly installments. Family*** 1 Year 60.00 $ ___________ ***Available to all family members under the age of 18 living at the same address. Only one publication per family. Give first names and initials of members to be included on a separate sheet of paper.
Businessmen's Booster Club -Minimum 25.00 $ ___________ Laminated Membership Card #101-L 1.00 $ ___________
DONATIONS... for WBH Land Purchase Fund 504 $ ___________ ... for operation of WBH (General Fund) 502 $ ___________ ... to the Bowhunter Support (Defense) Fund 505 $ ___________ ... to the Museum Fund 517 $ ___________