COUNCIL MEMBERSHIP APPLICATION

Please print this form out, complete it, and bring it with you to the monthly Board Meeting.

MEMBERSHIP INFORMATION SHEET

NAME: _______________________________________________
ADDRESS: ____________________________________________
CITY: ____________________ STATE: ________ ZIP: ________
PHONE #: ___________________FAX #: ___________________
E-MAIL: ____________________
PROFESSIONAL EXPERIENCE:

 

SUB-WATERSHED AREA: (i.e., Evans Creek, Sams Creek, etc.)

 

You are a stakeholder in "SWBC" because (check one or more as applies):

• You live in the watershed _____

• You work in the watershed _____

• You own property in the watershed _____

Are you willing to serve on a committee, board, volunteer for special projects? YES _____NO _____

If yes, please specify what skills, expertise, talents or other resources do you have that you would be willing to share with the council?
COMMENTS:



APPLICANT'S SIGNATURE: _______________________________
DATE: ______________

DUES, $12.00 PER YEAR (prorated $1/month for balance of calendar year)

 

| PRIVACY |

©2003-2004 Seven Basins Watershed Council, Inc.
P.O. Box 909, Gold Hill, OR 97525
Ph (541) 261-7796 ; Fax (541) 830-0261
contact@sevenbasins.org
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