San Joaquin Valley Chapter of the Wildlife Society

San Joaquin Valley Chapter of the Wildlife Society 2006 Membership Form

Date: ______

Last Name:______First Name:______M. I. :_____

Mailing Address:______

City:______State:_____ Zip Code:______

Work Phone:______Home Phone:______Fax:______

E-mail address:______

Employer/Affiliation:______

Areas of Interest: ______How would you like to receive our quarterly newsletter? _____ Hardcopy (snail mail) _____Electronically (MS Word) Are you a student? Yes No If yes, which school? ______

Would you be interested in serving on a committee or become an officer? ______

Annual Dues: $5.00 (make checks payable to “San Joaquin Valley Chapter-TWS”)

Mail forms with dues payment to:

San Joaquin Chapter of The Wildlife Society Attn: Membership 563 Dawson Morro Bay, CA 93442

For more information, contact Carie Wingert at: [email protected]