2007 Membership Form
(please print out and mail, making check
payable to the Waldemar Ager Association)
Mailing
Address: P. O. Box 1742, Eau Claire, WI 54702-1742
Name(s): ____________________________________________________________________
Address: ____________________________________________________________________
City/St./Zip: _________________________________________________________________
Telephone: ______________________ E-mail
Address: ____________________________
Membership
Category:
(Circle category below)
| General:
$25 |
Sustaining:
$50 |
Supporting:$100 |
Life:
$1,000 |
| Other:
(Indicate amount) $____________________ |
|
Donation Form
(Click on the links for a description of the special
funds. Your membership and donation may be in the same
check.)
In addition, I/we wish to contribute to the following funds:
If you are making a donation as a memorial or to honor
someone, please provide the name and addres of an individual
whom we may contact to properly acknowledge your gift.
Contact:
Potential New Members: Please
list name, mailing address, and telephone number
|
