$ 10.00 per Adult ________
                                                            $  5.00 per Youth ________                                                
                                                            $ 25.00 per Family________

NAME:_________________________________________________________________
                  (last)                (first)             (middle)

ADDRESS:___________________________________________________________________________
                  (street)           (city)         (state)        (zip)

PHONE:______________________________________________________________________________
                  (home)           (business)              (other)

DISTRICT:___________  TROOP/PACK/POST:_____________  COUNCIL:_______________________

How would you like to help Friends of Northwoods? __________________________________________

____________________________________________________________________________________

Would you like to make a donation?  YES / NO  If yes, how much or what? _______________________

____________________________________________________________________________________

Are you willing to work on fundraising projects?  YES / NO

What committee or area would you like to help in? ____________________________________________
        (please circle one or more)                              (other)
        1. Business Pledges                  6. Service Projects
        2. Individual Pledges                7. Membership
        3. Fundraising                       8. Communication
        4. Sales                             9. Publication
        5. Activities
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Print this page,tear off at the line above and mail to:

Friends of Northwoods
P.O. Box 356
Leslie, MI 49251-0356