Yes, I want to protect northern Michigan's water resources by
becoming a member of the Watershed Council!

(Instructions: Please print and complete this form and mail or fax to Tip of the Mitt Watershed Council.)

Please accept my tax-deductible gift of:

Name ________________________________________________________________

Primary Address ________________________________________________________

City_____________________________________State_______________Zip________

Phone___________________________

Email address:__________________________________________________________

Summer Address ________________________________________________________

City_____________________________________State_______________Zip________

Phone___________________________

Mail to my summer address from_________________ to _____________________

I live on the following water body _________________________________________

Account No: ________________________________________________________
Authorization No: (3 digit number on back of card): ________________________
Expiration Date: ____________________ Gift Amount: $_____________________
Name of Cardholder: __________________________________________________
Signature: __________________________________________________________

Please mail to:
Tip of the Mitt Watershed Council
426 Bay Street
Petoskey, MI 49770
Phone: 231.347.1181
Fax: 231.347.5928