Membership Form Home » Membership Form Row topography Shape Decorative svg added to top Membership Enrollment Form "*" indicates required fields CompanyThis field is for validation purposes and should be left unchanged.Contact InformationFirst Name*Last Name*Chain Property Address*Lake*Mailing Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone #1*Phone #2Email Address #1* Email Address #2 Volunteer InformationCheck all that apply.Be nominated for: Board Director: 3-year term Be appointed to one of these standing committees: Clean Boats / Clean Waters Membership Water Quality Fish & Habitat Channel Markers Program & Special Events Website Newsletter Lakes Planning Inspect boats at landing for invasive species. 2-hr weekend shifts, training is available Membership InformationI/we want to pay annual membership dues for 2026* $30 : Renewal Membership $30 : New Membership $100 - Sponsor A Day at Moen Boat Launch (includes annual dues) I/we want to help with an additional contribution in the amount of: Renewal Membership Price: New Membership Price: Sponsor a Day at Moen Boat Launch Price: Payment InformationTotal Payment MethodPayPal CheckoutCredit Card MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name
