Membership At Large Application, Izaak Walton League of America  

The Izaak Walton League of America - a non-profit conservation 
organization - is recognized as a Section 501(c)(3) public charity 
under the Internal Revenue Code. Minimum national dues are $36 
for individual and $54 for family memberships, which includes $4 
for Outdoor America magazine. Magazine is inseparable from dues. 
Chapter and Division dues may vary.

NAME ________________________________________________________________                                                                                                                 

Home Phone (___) _______    Business Phone (___) _______  

SPOUSE __________________ CHILD. & AGE ________________________________

ADDRESS ___________________________ City_____________________

State. ___ ZIP _________

DATE ____________       e-mail address __________________________________

Individual ------- $36   Family -----  $54   Student (18-21) --- $18 Youth  (under 18) -- $7.20

I wish to support the I.W.L.A. and it's conservation mission with this contribution $ __________ 

Make checks payable to: The Izaak Walton League of America, and mail to:

I.W.L.A. Inc.
707 Conservation Lane
Gaithersburg, MD 20878-2983

Alternatively, you may join online at www.iwla.org 
or contact Robert Stegmier (Michigan National Director) 
Tel: 616-866-4769 
E-mail: rstegmier@ameritech.net