Text Box: Applicant Information

Text Box: WATERFOWL U.S.A.

Text Box: Northwest Indiana Chapter

Text Box: Membership Application

Text Box: Print out the application, complete the information and return with payment.

Text Box: Waterfowl U.S.A. Northwest Indiana Chapter 1707 South Cline Avenue Griffith, Indiana 46319    

Text Box: First Name

Text Box: Middle

Text Box: Last Name

Text Box: Current Street Address

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Text Box: Home Telephone

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Text Box: E-Mail Address

Text Box: Please contact me VIA E-Mail about upcoming chapter events

Text Box: New Membership

Text Box: Renewing Membership

Text Box: Youth Membership ....................( $15.00 per year) Includes The Following: ·   A one Year Youth Membership to the Northwest Indiana Chapter of Waterfowl U.S.A. ·   6 issues of Waterfowl Magazine ·   Membership Decal ·   Membership ID Card ·   1 entry in the special Youth Hunt Drawing, for waterfowl hunting at the Jerry Allen Marsh, Located in Boone Grove, Indiana  

Text Box: Regular Membership ....................( $25.00 per year) Includes The Following: ·   A 1 Year Membership to the Northwest Indiana Chapter of Waterfowl U.S.A. ·   6 issues of Waterfowl Magazine ·   Membership Decal ·   Membership ID Card ·   Qualify to enter the " Members Only" hunt raffles.

Text Box: Sponsor Membership ....................( $275.00 per year)  Includes The Following: ·   A 1 Year Membership to the Northwest Indiana Chapter of        Waterfowl U.S.A. ·   6 issues of Waterfowl Magazine ·   Sponsor Decal ·   Membership ID Card ·   Qualify to enter the " Members Only" hunt raffles. ·   Embroidered W.U.S.A. Sponsor Cap ·   Waterfowl U.S.A. License Plate ·   Membership Card ·  Sponsor Decal