Request Form

Yes, I would like to join the INTERNATIONAL NORTHWEST PARKS & RECREATION ASSOCIATION

Please process my membership request as indicated below:

____Agency (over 25,000 pop) $60 USA funds

____Agency (under 25,000) $30 USA funds

____Professional (Indv.) $15 USA funds

____Associate $10 USA funds

____Commercial $100 USA Funds

Application Information :

Name:_____________________________

Agency:____________________________

Title:______________________________

Address:___________________________

State/Province:______________________

Zip:_______________________________

Phone: (      )________________________

Email:_____________________________

Mail Payment to:

INPRA Executive Director

Ken Heany, Executive Director

3324 Olympic Blvd.

University Place, WA 98466

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