M E M B E R S H I P  F O R M
                                            
                                            
                                            

Name -------------------------------------------------------------------       

Mailing Address --------------------------------------------------------

Telephone ----------------------------------

Email Address ------------------------------




Membership Dues
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Individual ($5.00)

Supporting Member ($10.00)

Society Membership (1-10 members = $5.00), (11-25 members = $10.00), (26-50 members = $20.00),

(51+ members = $35)


Submit this form with check or money order to:

Don Smith 
PO Box 485 
Bismarck, ND 58502-0485