Friends of Wilson Island
Membership Form
Date: _____________________
Name: ______________________________________
Address: ______________________________________
______________________________________
______________________________________
Phone: ______________________________________
Membership Type:
_____ Family - $20
_____ Single - $15
Note: Family membership gives two votes.
Instructions: Please print off the form above, send the filled out form and a check (made out to Friends of Wilson Island) to the following address:
Friends Of Wilson Island
PO Box 294
Missouri Valley, IA 51555