Membership Application - Chehalis River Council

CRC logoMembership Application

To the Chehalis River Council:


I want to join you in your water quality and resource efforts. Please accept this application to become a member of the Council.

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First name - - - - - - - - - - - - - - Last Name

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Street or mailing address

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City, State and Zip Code

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Telephone number (optional)

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Agency, Employer, or Area of Interest

Dues (choose one)
$25 Voting Regular Membership
$25 State, Federal, or Local Agency
Nonvoting State, Federal
or Local Agency, no dues
$5 Student Membership
$50 Sponsor (regular membership plus extra gift)
$100 Patron (regular membership plus extra gift)

Please use your Web Browser to print this application, then mail it to the
CRC
417 N. Pearl St.
Centralia, WA 98531
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