Mail-in Payment Membership Form

Kokanee Power of Oregon Annual Membership Application

OREGON FISHERIES ENHANCEMENT FOUNDATION INC. MEMBERSHIP

3002 NE Glacier Way, Corvallis OR 97330 | www.kokaneepoweroregon.com

Please select the appropriate membership. *

New Membership

Renewal Membership

Date

Member Name *

Business Name

Spouse's Name

Junior's Name #1

Junior’s Birthdate

Month #1

Day #1

Year #1

Junior's Name #2

Junior’s Birthdate

Month #2

Day #2

Year #2

Please provide the name(s) and birthdate(s) for any additional children under 18

Address *

Country

City

State

Zip code

Email *

Phone

Mobile

Membership Year *

Please choose your membership level.

Choose a Membership Level *

Individual Membership | $35.00

Family Membership | $50.00 - Member, Spouse, and children under 18yrs.

Business Membership | $100.00 - ($100 Raffle Donation covers fee - Use Mail in form)

Lifetime Membership | $500.00 Minimum Donation. Enter amount below.

If making a tackle or material donation please use the mail in membership form. Just enter the dollar amount of your donation. No need to mail in the form.

Enter Donation Amount

Mail-in Membership Form

After your registration is submitted, you will receive an email with your registration information. Please print out and mail the registration along with your payment to:

Kokanee Power of Oregon
PO Box 989
Philomath, OR 97370