MEMBERSHIP INVITATION

DUES:

$35.00 INDIVIDUAL VOTING MEMBERSHIP / BUSINESSES

$60.00 HOUSEHOLD VOTING MEMBERSHIP (2 ADULTS)

$20.00 MAILINGS ONLY MEMBERSHIP

$5.00 ANNUAL WEBSITE FEE

PLEASE PROVIDE THE FOLLOWING INFORMATION:

NAME________________________________________________________________

ADDRESS_____________________________________________________________

CITY________________________________ STATE_________ ZIP CODE_________

HOME PHONE_________________________WORK PHONE____________________

E-MAIL ADDRESS_____________________________________________________________

AREA(S) OF INTEREST OR EXPERTISE____________________________________________________________

______________________________________________________________________

COMMENTS___________________________________________________________

______________________________________________________________________

______________________________________________________________________

13173 US Highway 12, P. O. Box 64, Packwood WA 98361-0064

Phone: 360-494-2223, Fax: 360-494-2216

E-mail: dpa@lewiscounty.com, Web Site: www.destinationpackwood.com