PALOUSE AUDUBON MEMBERSHIP APPLICATION                                      C1ZY050Z

Financially supports the programs and activities of the Palouse Audubon Society and includes an annual subscription to THE PRAIRIE OWL newsletter.

         Annual Membership   $15.00                                                                   For questions call: (208) 874-3207

             NAME ____________________________________________             ADDRESS _________________________________________

  CITY ____________________________________    State ____________________               Zip _________________________

  PHONE _________________________________        EMAIL ___________________________________________________

Return this form with your check to: Palouse Audubon Society, PO Box 3606, Moscow, ID 83843-1914

Check one:  o  I PREFER TO READ THE PRAIRIE OWL ON THE WEBSITE

(notice will be sent by email after edition has been posted on the website)

o   PLEASE SEND A HARD COPY OF THE PRAIRIE OWL