NORTH COUNTRY BIRD CLUB

P. O. Box 634
Watertown, NY 13601

NORTH COUNTRY BIRD CLUB MEMBERSHIP

Membership is for the calendar year. Dues are per individual.
Renewals are due by January 1st. To ensure that you receive Club
materials, be sure to give your correct mailing address below.

Name(s): _________________________________________
E-mail: ___________________________________________
Address: _________________________________________
City: ______________________ State: ____ Zip: _________

Regular at $10.00 Number ____ Total $_____________

Sponsor at $15.00 Number ____ Total $_____________
Patron at $20.00 Number ____ Total $_____________
___ New ___ Renewal Total Dues $_____________

Dues payable to: North Country Bird Club Send Newsletter by:
P.O. Box 634 ___ e-mail ___ USPS
Year: 2018 Watertown, NY 13601 (please choose one)