Please print and fill out this page: 

Name: ___________________________________

Email: ___________________________________

Telephone: _____________________ Cell or Landline? ______

Address: ___________________________________

___________________________________

I am including a check for annual dues, payable to "Friends of Putnam Park," for

 ___ $10 an individual

 ___ $20 a household

Optional: I am including an additional contribution of $_____

Please mail your completed form and check to: 

Dave Lonzarich, Treasurer

Friends of Putnam Park

1738 Coolidge Court

Eau Claire, WI 54701