<p> San Joaquin Valley Chapter of the Wildlife Society 2006 Membership Form</p><p>Date: ______</p><p>Last Name:______First Name:______M. I. :_____</p><p>Mailing Address:______</p><p>City:______State:_____ Zip Code:______</p><p>Work Phone:______Home Phone:______Fax:______</p><p>E-mail address:______</p><p>Employer/Affiliation:______</p><p>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? ______</p><p>Would you be interested in serving on a committee or become an officer? ______</p><p>Annual Dues: $5.00 (make checks payable to “San Joaquin Valley Chapter-TWS”)</p><p>Mail forms with dues payment to:</p><p>San Joaquin Chapter of The Wildlife Society Attn: Membership 563 Dawson Morro Bay, CA 93442</p><p>For more information, contact Carie Wingert at: [email protected]</p>