South Carolina Waterfowl Association

	Place a check by desired membership
___	$10 Woodie Membership	(up to 16 years of age)Hat pin, window decal.
___	$25 Regular Membership	SCWA magazine, window decal.
___	$50 Contributing Membership	SCWA magazine, window decal and member pin.
___	$100 Donor Membership	SCWA magazine, window decal, donor hat and member pin.
___	$250 Sponsor Membership	SCWA magazine, window decal, sponsor gift, sponsor hat, sponsor hat pin, couples ticket to the local chapter conservation dinner and invitations to local sponsor events.
___	$5,000 Life Membership (payable over 5 years)	SCWA magazine, window decal, life member gift, life member name tag and plaque, life member hat, life member pin, couples ticket to the local chapter conservation dinner and invitations to local sponsor events.
___	Corporate Membership	Please call SCWA for more information on our corporate memberships, 803-452-6001

Name:	_____________________________________________________
Signature:	_____________________________________________________
Address:	_____________________________________________________
City:	______________________State:_______________Zip:_________
County:	_____________________________________________________
Phone:	_________________________Work:_______________________
E-Mail:	_____________________________________________________

The amount of your donation above the retail value of items received is tax deductible.
I wish to pay by:
____Check ____Visa____MasterCard____American Express____Discover

Amount Enclosed $_______________ Name on Card __________________________

Card Number:_________________________________ Exp. Date:_______________

Retail value of memberships are:
Regular $5; Contributing $16; Donor $24; Sponsor $102

fax this application to (803) 452-6032 or call the SCWA office for details (803) 452-6001.

Mailing Address
South Carolina Waterfowl Association
9833 Old River Road
Pinewood, S.C. 29125