Membership Type:(see below)________________________________

Youth/Senior: Applicant is either fourteen or younger; or sixty-five or older on the date of application.

Professional: Applicant working in an occupation directly involving wildlife, or related to wildlife, who wishes to be distinguished as a Professional member.

Life member: Applicant may make a one time or four semi-annual donation payments.

Benefactor: Benefactor members are titled "Friends of the Foundation" and receive special recognition for their contributions.

Associate: Applicant is a non-commercial entity sharing the concerns of NAPF. Annual dues may be paid semi-annually.

Commercial: Applicant is a commercial entity which shares the concerns of NAPF. Annual dues may be paid semi-annually.

Please indicate application type:   ___New   ___Address Change   ___Renewal of Member #:______

Contribution:

         ______$10 Youth/Senior     ______$100 Sponsoring

         ______$20 Supporting       ______$200 Sustaining

         ______$30 Family                      ______$1000 Life

         ______$50 Professional             ______$2000 Benefactor

Associate Member:     $150 Supporting, $300 Sponsoring, $______Other

Commercial Member: $150 Supporting, $500 Sponsoring, $______Other

Personal Information:

         Date:__________________________________________________

         Name:___________________________________ Age:__________

         DBA: _________________________________________________

         Address:_______________________________________________

         City: ____________________State:_________ Zip:_____________

         Country: _______________________________________________

         Phone:_________________________________________________

Mail to:

         NORTH AMERICAN PRONGHORN FOUNDATION

         P.O. Box 1383

         Rawlins, WY 82301

North American Pronghorn Foundation