Bear Lake Watch Member Application Form

Bear Lake Watch is making a difference! Yes! Count Me In! I want to join with Bear Lake Watch in preserving Bear Lake.
Name:
Address:
City:	State:	Zip:
Phone:	E-mail address:
Credit card number	Expiration date

Individual Membership	Couple Membership	Gold Membership	Business Membership	Platinum Membership
$25	$50	$100	$250	$1000

I would like to make seperate donation for:
(please include the amount and purpose)

OR
send a check to:

Bear Lake Watch, Inc.
P.O. Box 205
St. Charles, Idaho, 83272

If sending a check, please be sure to include you name, address and e-mail so we can send you our quarterly news letter and important e-mail updates.