Friends of Bass Lake (501 c-3 tax deductible donation)

"Investigating and advocating for the restoration of a healthy and sustainable Bass Lake ecosystem and to be deeply involved in securing Bass Lake's future as a community and re-creational asset."

Membership Application Form: Individual or Business (circle one)

Date: __________________

Individual or Business Information:

Name: ________________________________________________________________

Address: ________________________________________________________________

Home/Business Phone: __________________________

Cell Phone: _________________________

Email Address: _______________________________________________________________

Membership Fee:

Individual $25

Business $100

Please make checks payable to: Friends of Bass Lake

Please print this page and return form and payment to:

Friends of Bass Lake

c/o Scott Carpenter, President

3924 Randall Ave

St. Louis Park, MN 55416