Woodland Owners of the
                                         Southern Alleghenies (WOSA)
                                         Annual Membership Form
                                         (Membership runs per calendar year.)

     Name _____________________________________________________________________________

     Home Address____________________________________________________________________

     City, State, Zip_____________________________________________________________________

     Phone No.______________________   Email___________________________________________

     # of Acres Owned__________________     County____________________________________

     Property Address if different from your home address:
     Street, City, State, Zip_____________________________________________________________

     Do you, or have you had, a Forest Stewardship Plan? ___________________________

     Would you like the Service Forester to walk your property (free of charge) and 

     discuss your concerns and goals? _____________

     Single: $15_______  Family: $20_______  Sponsor $50________  Associate $15______
           Single and Family members are voting individuals or families who own forest land.
           Sponsor members are non-voting public or private organizations, which own forest land, or have a public

               or commercial interest in wood products, land or wildlife preservation, and support WOSA.
           Associate members are non-voting individuals who do not own forest land but endorse and support WOSA.

     If Family, please list other members: _____________________________________________

     Amount enclosed  $___________

     Make check payable to WOSA

     Mail to WOSA P. O. Box 253 Everett, PA 15537

     Thank you for your support!!
     Laura Jackson, Membership Chair

     Woodland Owners of the

     Southern Alleghenies