Annual Membership and Renewal Application

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Annual Membership and Renewal Application


Annual Membership and Renewal Application

Join other like-minded people, local businesses, home owners’ associations and organizations to help the Lake Wisconsin Alliance (LWA) improve the water quality and experience of the lake we love.

Mission Statement:  The LWA endeavors to balance the diverse interests of the Lake Wisconsin community while improving water quality, recreational opportunities and sustaining a healthy ecosystem within the Lake Wisconsin watershed.

Last Name: ____________________________   First Name: ____________________________

Mailing Address: _______________________________________________________________

City, State, Zip Code: ____________________________________________________________

Phone Number:  ___________________________________________

Email Address: _________________________________________________________________

If applying as a business, Name of Business: _________________________________________

Membership Level:

______ Individual Annual Membership $20.00       ______ Business Annual Membership $50.00

______ Additional Contribution of $______________

Membership is for the current calendar year.

Join/give on our website at: or by completing and mailing this application form to the address below.  Make checks payable to “Lake Wisconsin Alliance” and
submit to:

Lake Wisconsin Alliance

PO Box 172

Poynette, WI 53955

Contact:  Kirk Boehm | 608-635-8851 | [email protected]

Lake Wisconsin Alliance is a tax exempt 501(c)3 organization.  Your contribution is tax deductible.   Thank you for your support.  It is greatly appreciated.