Butte des Morts Conservation Club, Inc.
Membership Application
Date of Application___________________________
Name__________________________________________________________________________
Mailing Address__________________________________________________________________
City, State, Zip___________________________________________________________________
Telephone (Home)__________________________Other________________________________
E-mail Address___________________________________________________________________
Is this a renewal application Yes_________ No_________
Print this form and return with $25 Payment to:
BDMCC, PO Box 385, Butte des Morts, WI, 54927-0385
Note: The cost of producing and mailing newsletters is very expensive. You can help put this money back into the habitat by foregoing the newsletter and getting your information from this website. You will still receive other important mailings and notices. Please select your choice.
_______ Please send me the periodic newsletters. ________ E-MAIL ME at _______________________________________________
_______ Please do not send me the newsletter. I will get my information from the website.
(For Club Use)
Date Received_________________ _________Entered - Secretary / Date__________
Received by___________________ _________ Entered - Treasurer / Date__________
_________ Entered - Roster / Date __________
Comments:_____________________________________________________________________
_____________________________________________________________________________
