Land Ethic Leaders Registration Form

Class Selections

  #People Class Name Date Cost Total
$  $ 
Tuition Total $ 

Contact Information

Name(s) *
Organization (if applicable)
Address *
Address 2
City/State/Zip *  /  / 
Telephone *
Email *
*Required Fields

Please list any dietary restrictions or other comments about your registration.

Membership Information

If you would like to support the ongoing work of the Aldo Leopold Foundation by joining or renewing your membership, please complete the following:

.
.

Membership Type:    

I would like to give the following amount for my membership:

Payment

Total charges: $

Your information will be sent securely over an encrypted connection.

  CC #     CVV   What's This? 
  Exp.  /         

Billing contact information (if different from above):

Full Name
Address
City/State/Zip /  / 
Phone Number

If you prefer to pay by check, please mail the above information along with your check payable to the
Aldo Leopold Foundation to:

Land Ethic Leaders Registration
Aldo Leopold Foundation
P.O. Box 77
Baraboo, WI 53913

If you have questions about your registration, please contact Jeannine Richards at (608) 355-0279, ex. 25, or jeannine@aldoleopold.org.