Membership Application

Fill out this form online, print, mail, or fax.
For security reasons, please do not email this form.

Name:

Spouse's Name:

Home Address:

City:

State:

Zip Code:

Home Telephone:

Home Email Address:

Cell Phone :

Company/Organization:

Business Address:

City:

State:

Zip Code:

Send mail to:

Home Business

Business Telephone:

Business Fax:

Business Email Address:

Business website URL:

Job Title & Skills:

How did you learn
about the DWWC:

Friend – (Please give name)
Annual auction
Show booth
The Banner or Monthly Newsletter
Newspaper
Website
Other

New Member Dues Specials

Jan-June — $75
July-Sept — $100 for 1½ years
Oct-Dec — $75 for 1¼ years

All renewals are due January 1st of each year

Membership levels:

Family $75
Outfitter $50
Corporate $200 (3 persons)
Our Heroes - Complimentary
Lifetime $750

Form of payment:

American Express Discover Mastercard
Visa Check

Credit card number:

Expiration date:

Name on credit card:

Signature & date:

Return this form with your payment to:
Dallas Woods and Waters Club
1221 West Campbell Road, Suite 215
Richardson, Texas 75080
Fax: 214 570-8702

For security reasons, please do not email this form.

Date:	February 9, 2012
Time:	6:30 dinner
Speaker:	Mike Pritchard "Hunting in Texas"
Location	Hyatt Place Dallas-North/by the Galleria 5229 Spring Valley Road Dallas, Texas 75254 $30 per person. Walk-ins are welcome, but are subject to food and space availability. $35 at the Door Call 214-570-8700 by Monday, February 6th to reserve your seat.