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Make cheques payable to: Nature Regina.
Mail to: Nature Regina, Box 291, Regina, SK S4P 3A1

Name: _______________________________________________________________

Address: _____________________________________________________________

City: _________________________________________________________________

Postal Code:________________________Telephone: _______________________

Email (optional):_____________________________________________

New membership________ or Renewal____________

Fees for Nature Regina:
Single ($12)________ Family ($20)________ Group ($25)________
Junior (under 18) ($10)________ Senior (65 or older) ($10)________

How many people are included in your Family membership?______

Donations to Nature Regina (optional):
Friends ($24 & under) Supporter ($25-$49) Patron ($50-$99) Benefactor ($100 & over)
Amount of your donation $______

Please indicate in which fund you would like your donation placed:
Conservation Fund_____ General_____

Acknowledge my name in the newsletter
yes_______ or no_______
(donations are tax deductible)

Total amount enclosed: $_________________________

Please note: as of November 2009, Nature Regina is no longer accepting membership fees on behalf of Nature Saskatchewan. We continue to be an affilate of Nature Saskatchewan, and encourage Nature Regina members to participate in Nature Saskatchewan, but we please ask our members to send their Nature Saskatchewan memberships directly to Nature Saskatchewan at Room 206, 1860 Lorne St., Regina, SK, S4P 2L7
This change has no effect on the benefits of membership in either organization.

Program Survey and Volunteering (Optional information):
(Please check only 2)
Areas of Interest:
Plants ___ Birds ___ Mammals ___ Landscaping/Gardening ___ Insects ___ Reptiles/Amphibians ___ Photography ___ Other _______________

Newsletter ___ Hidden Valley Sanctuary ___ Bird Alert ___ Birdfeeders/Birdhouses ___ Children's Programs ___ Field Trips ___ Conservation/Advocacy ___ Other __________________________

If you are interested in volunteering some of your time, please check here _