Friends of the Hennepin Canal

Sheffield, IL 61361

Friends of the Hennepin Canal

Membership Application

Name: __________________________________________________________________________

Family Names: ____________________________________________________________________

Contact Name: ____________________________________________________________________

Address: _________________________________________________________________________

City:___________________________________________  State: _________  Zip: _______________

Home Phone: __________________________  Business Phone: ______________________________

E-Mail: __________________________________________________________________________

Please check the appropriate membership category:

   $20.00 Individual
   $30.00 Family
   $50.00 Not-For-Profit
   $50.00 Municipality
$100.00 Business/Corporation

Mail the completed application and check to:

    Friends of the Hennepin Canal
    % Pat Stier, Treasurer
    410 West Railroad St.
    Sheffield, IL 61361