membership form

WINSTON COUNTY SMITH LAKE ADVOCACY, INC.
MEMBERSHIP APPLICATION FORM


Mission Statement: The mission of Winston County Smith Lake Advocacy is to preserve and protect the environmental quality of Lewis Smith Lake and its tributaries through education of the public and the promotion and implementation of sound environmental practices.

Name____________________________________________ (Please print)

Mailing Address_____________________________________
______________________________________
Phone______________________________________

Email address_______________________________ (all notices and information will be sent to your email address unless you specify phone or US mail)
Dues enclosed_________ ($10 per household or business per year; $100 lifetime) Make check payable to “WCSLAI”
Mail check and form to: Winston County Smith Lake Advocacy, Inc. P. O. Box 435 Arley, AL 35541
2009 Board of Directors

Linda Atkinson
Larry Barkey
Bob Beatty
Kitty Chance
Mary Ann Crunk
Paul Gillette
Tom Grubbs
Barry Johnson
Burt Jones
Judy Lambert
LaVerne Matheson
Dennis Quinn