Farm Forestry Association Membership Application

Name _____________________________________ [ ] Renewal [ ] New Member
IF THIS IS A FAMILY MEMBERSHIP:
Spouse's Name ____________________________________________________

Address __________________________________________________________
Local Chapter _____________________________________________________
City, State and Zip _________________________________________________
Telephone ( ) ____________________________________________________
E-Mail Address ____________________________________________________

Dues Level (Please Check One)
[ ] General – Owning 1-40 acres                     $65 ______
[ ] General – Owning 41-200 acres                 $125 ______
[ ] General – Owning over 200 acres              $175 ______
[ ] Lifetime $1700 (one-time payment)
[ ] Additional Voluntary Contribution to Support WFFA - $ ________
[ ] Associate – Not owning forest land             $65 ______

Your membership in one local chapter is included with your membership to WFFA.

Please list your chapter preference (or if you don’t know it, put your county)

__________________________

Additional Chapter Memberships @ $10 each ___________

Circle desired chapters(s): Clark, Cowlitz, Grays Harbor, Kittitas, Lewis,

North Central, Northeast Washington, Olympic, Pacific, Pierce, South Sound,

Spokane, Upper Puget Sound, Whatcom

TOTAL AMOUNT ENCLOSED $_____________

Please Print This Form and Mail with a Check Made Payable to "WFFA" to:

Washington Farm Forestry Association
P.O. Box 1010
Chehalis, WA 98532

Additional contact information:

(360) 736-5750

info@wafarmforestry.com