Membership Application Form

 

NAME: _______________________________________________

 

 

ADDRESS: _____________________________________________

 

 

CITY, STATE, ZIP: _______________________________________

 

 

EMAIL: _______________________________________________

 

 

TELEPHONE:___________________________________________

 

Amount Enclosed:____________

 

Dues are $10 per year. Please print this page and sent it along with your check (payable to WI-IL NARGS) or cash to the treasurer: Jean Halverson, P.O. Box 101, Dodgeville WI 53533