Thank you for your interest in becoming a member.  Annual dues are $15.00 for an individual, $25.00 for a family membership.  Please write your check payable to the Central Iowa Water Garden Association and mail it along with the application to our membership secretaries:

CIWGA Membership
Carol Scheid
68065 180th Street
Nevada, IA  50201

Your name: ___________________________________________________________

Other name to include as family member: ____________________________________

Address: ____________________________________________________________

City: _______________________        State:________    Zip:___________

Home phone:____________________   E-mail address:________________________

Membership type: Individual:___             Family:____

How would you like to receive the monthly newsletter?
      ___electronic mail (includes color as well as photographs)
___regular postal mail (black and white, no photographs)

How long have you been interested in ponds? _______________________

Do you have any ponds? _____   Size? _____________

What club programs would you  be interested in? _____________________________

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What special talents or expertise can you offer? ______________________________

Additional comments: __________________________________________________

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