On-line Membership Application

On-Line Membership Application

Membership Information:

First Name
†

Email If none, use NA
†

Phone (Home) If none, skip this
() -†

State:
†

Country:

 

Last Name
†

Address
†

City:
†

Zip Code:
†

Country (if not USA):†

 

† - Required Fields

Membership Fiscal Year:
October 1st - September 30th

New Members Only:
Oct. 1st - Mar. 31st (Full Membership Price)
Apr. 1st - Sept. 30th (1/2 Membership Price)
w/ Full Membership Renewal due on October 1st of each year

Renewals are Full Membership Price no matter date received

Please check one:

 New Member

 Renewal

If you are a new member or you are changing your current status, please check one of the following:

Membership Type

Dues

Bonuses

 Sprig (under 16 y/o)

$10.00

MWA Sticker, Newsletter

 Regular Membership 1-year

$25.00

MWA Sticker, Newsletter

 Regular Membership 2-year

$50.00

MWA Sticker, Newsletter, Kwack Whacker Duck Call

 Life Membership

$300.00

MWA Sticker, Newsletter, Cedar Wood Duck Box

 Corporate Sponsor

$75.00

4 Business Card Ads in Newsletter

 Gold Corporate Sponsor
Bronze Status

$250.00

4 - ¼ page Ads in Newsletter, Certificate

 Platinum Corporate Sponsor
Silver Status

$500.00

Decoy, 4 - ¼ page Ads in Newsletter, Cedar Wood Duck Box

   

Please fill out form and click the 'Submit' button, then send appropriate payment to:

Missouri Waterfowl Association
P.O. Box 656
Columbia, MO 65205-0656

© 2006 Missouri Waterfowl Association. All rights reserved.
The Missouri Waterfowl Association is a Tax Exempt 501(c) 4 corporation.

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