Membership Application

Name ________________________________ Date ________________

Address __________________________________________________

City __________________________ State ______ Zip ____________

Phone (______) ________________ E-mail ______________________

Membership Category
Associate/Active $25 ( ) Friends of the Society $15 ( )  None ( )
Renewal ( )   New Member ( )   NPWS Signature Member Yes __ No __

Total Due

Amount Enclosed $_____________ Check # ___________

Make checks payable to NPWS.

Send checks to: 

Northern Plains Watercolor Society
PO Box 849
Rapid City, SD 57709-9724