Membership
Application Form
Please print this page,
fill in the information and send with payment
Primary Contact Name:
Title:
Company/Organization:
Address:
City/State/Zip:
Phone/Fax:
e-mail:
Alternate
Contact Name:
Title:
Company/Organization:
Address:
City/State/Zip:
Phone/Fax:
e-mail:
Membership Level: (please
check one)
 |
$50 Individual
Citizen |
 |
$95 Individual
Business Professional |
 |
$295 Small
Business (fewer than 10 employees) or Non-Profit Organization |
 |
$495 Corporate |
 |
$1500 Corporate
Plus |
 |
$3,500 Sponsor |
 |
$8,000 Benefactor |
WEI is a non-profit 501c(3) corporation, making your contribution
tax deductible.
Please make check payable to Wisconsin Environmental Initiative.
Return completed form with membership fee to:
Wisconsin Environmental Initiative
16 N. Carroll St., Suite 840
Madison, WI 53703
Thank you very much for joining Wisconsin Environmental
Initiative.
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