Membership Application

Yes, I want to demonstrate my commitment to the Geneva Lake Conservancy's efforts to safeguard our land and waters.

( ) $30 Naturalist

( ) $60 Steward

( ) $100 Advocate

( ) $150 Protector

( ) $250 Guardian

( ) $500 Benefactor

( ) $1,000 Stewardship Society

( ) $5,000 Preservation Society

___ Enclosed is my tax-deductible membership check

___ I authorize the Geneva Lake Conservancy to post charges to my Visa or MasterCard credit account in the amount of $____________

Credit Card No__________________________________Exp. Date__________________

Signature_______________________________________Date_____________________

Please send more info on:

Donor(s):______________________________________________________________

Address:_______________________________________________________________

______________________________________________________________________

Phone:________________________________________________________________

E-mail:________________________________________________________________

Please mail to:

Geneva Lake Conservancy
398 Mill Street
P.O. Box 588
Fontana, WI 53125

Phone: (262) 275-5700
Fax: (262) 275-0579