Become a Member of the Wildest Group in Town!

Print out this form and send it with your check to the address below.

Last Name: ____________________________________

First Name: ___________________________________

Address: _____________________________________

City: _____________ State: _____ Zip Code: _______

Phone: ______________________________________

RHWA Zoo Membership:
$35.00 Individual Membership	$110.00 Family Membership
$65.00 Individual Plus 1	$110.00 Couple Plus Two
RHWA Museum Membership:
$35.00 Individual Membership	$110.00 Family Membership
$65.00 Individual Plus 1	$110.00 Couple Plus Two
RHWA Zoo and Museum Combo Membership:
$59 Individual	$300.00 Supporter
$110 Individual Plus 1	$500.00 Caregiver
$185 Family	$750.00 Naturalist
$185 Couple Plus 2	$1,000.00 Visionary
New
Renewal

If Family or Couple Plus Two Membership, list 2nd cardholder's name:

____________________________________

Names of children on Family Membership:

_____________________ _____________________

_____________________ _____________________

_____________________ _____________________

- Send membership form and check to -
Rolling Hills Wildlife Adventure
Membership Department
625 N. Hedville Road, Salina, KS 67401
(785) 827-9488