Georgia Wilderness Society
Membership Application

Georgia Wilderness Society
Membership Application


MY DUES ARE FOR CALENDAR YEAR    __________

Name ______________________________________________

Address ____________________________________________

___________________________________________________

Email ______________________________________________

Phone _____________________________________________


Check One:    ____ Individual - $20.00

                      ____ Family - $30.00

                      ____ Student - $10.00


Make check payable to Georgia Wilderness Society 
and mail to:

Georgia Wilderness Society
c/o Susan Bush
99 Emmette Drive
Dawsonville, GA 30534