M.D.H.A. Membership Application 

http://www.midha.org/index.htm

Return Form & Payment (check or money order) to: 
Michigan Duck Hunters Association PO Box 20, Midland,  MI   48640

(  ) New          (  ) Renewal 

Name___________________________________________________________________

Address_________________________________________________________________

City_______________________________________Zip___________________________

Phone #(_____)_____-__________      (   ) Residence   (   ) Business

E mail Address___________________________________________________________

(  ) $25 General Chapter Affiliated Membership

Membership Card, MDHA Window Decal,  State Duck Stamp, and 1 Year subscription to "The Waterfowler" the official publication of MDHA

(  ) $500 Lifetime Chapter Affiliated Membership

(  ) $250 Senior (62 years of age) Lifetime Chapter Affiliated Membership

 (copy of Drivers License or State Identification Card as proof of age required)

Life Member Card, MDHA Life Member Window Decal, Yearly State Duck Stamp, Yearly subscription to "The Waterfowler" the official publication of MDHA, MDHA Life Member Certificate, MDHA State Duck Stamp Print w/ jacket (for that  year of  membership purchase), and Recognition as Life Member in "The Waterfowler". 

Please indicate the Chapter which you wish to be affiliated with;

(   ) Bluewater, (   ) Lakeshore, (   ) Macatawa Bay,

 (   ) Saginaw Bay, (   ) West Michigan, (   ) WebFoot Internet chapter, (   ) Not Sure?,

(   ) $250 Conservation Donor Membership *
MDHA Conservation Donor Certificate, 1 Year subscription to; "e;The Waterfowler" the official publication of MDHA, Current Years Limited Edition State Duck Stamp Print, and Recognition as Conservation Donor in "The Waterfowler"

(   ) $500 Conservation Sponsor Membership
MDHA Conservation Sponsor Certificate, 1 Year subscription to "The Waterfowler" the official publication of MDHA, Current Years Matted, Limited Edition State Duck Stamp Print, and Recognition as Conservation Sponsor in "The Waterfowler"

(   ) $1,000 Conservation Partner Membership
MDHA Conservation Partner Certificate, 1 Year subscription to "The Waterfowler" the official publication of MDHA, Current Years Matted and Framed, Limited Edition State Duck Stamp Print, MDHA Lapel Pin, and Recognition as Conservation Partner in "The Waterfowler"



The amount of your donation above the retail value of items received is not tax deductible. Retail value of memberships are: Donor $ 90.00, Sponsor $ 110.00, Partner $ 160.00.