Membership Form 2011 Text Version

I hereby submit an application for membership in the Missouri Sedimentation Action Coalition (MSAC). This application recognizes the formation of MSAC as a non-profit corporation organized under the laws of the State of South Dakota, to be governed by a Board of Directors of eight members, one to be elected from each of the classes listed below by members of that Class, and the other four to be elected at large. Officers of the corporation will be elected from within the Board of Directors by the Directors, and will have the duties and responsibilities as set forth in the By-Laws. I also understand that membership is voluntary and is renewable annually. Further, I also understand that memberships are to be renewed on the first day of January of each year, and that membership begun on other than that date shall be prorated to the nearest first day of a month for the first year of membership.

Class I. Government, to include states, counties, municipalities, Native American Tribes, water and sanitary districts, and any other unit of goverment that has the ability to levy a tax, or is supported by another government agency through appropriations.
Class II. Organizations, to include any group of body that has a membership that pays dues to said organization.
Class III. Commercial, to include any company, including corporations, partnerships, or individuals that conduct a business.
Class IV. Individual, also classified as Personal.

The following dues structure shall remain in effect until changed by the Board of Directors, as set forth in the By-Laws of the Corporation.
Class I. States: Resolution of Support
Class I. Counties: $1,000
Class I. Municipalities (Over 50,000 population - $5,000) (10,000 to 49,999 population - $2,500) (1,000 to 9,999 population - $500) (Less than 1,000 population - $250) Population to be determined by last census.
Class I. Native American Tribes: $1,000
Class I. Other government entities: $1,000
Class II. Organizations: $0.25 per member; Minimum $50
Class III. Commercial: Minimum $100
Class IV. Individual: Minimum $25

The above dues structure shows minimum suggested dues. Any increase over those amounts would be sincerely appreciated. Please circle your membership class.

Any questions, comments, or requests for more information may be directed to Sandra Korkow, executive director at PO Box 2, Springfield, SD  57062 or phone 605-369-2745 or email: sandrak@gwtc.net.

Membership Name: __________________________________

Membership Class: __________________________________

Address: Street/PO Box _______________________________

City, State: _________________________________________

Zip Code: _____________________

Telephone/FAX: _________________________________________

Email: ______________________________________________

Send my newsletters by: Email:  YES /  NO                Both Email/ Mail:  YES / NO

Contact: _______________________________________________

Please mail this form to: MSAC, PO Box 2, Springfield, SD  57062