Print this form and mail it with your payment to the address at the bottom.
	2008 MEMBERSHIP REGISTRATION                         (DUE FEBRUARY 2008)
Name (please print or type)  __________________________________________________________
Occupation  ______________________________________________________________
Affiliation  _______________________________________________________________ (Jurisdiction, organization, company, etc.)
Mailing Address   __________________________________________________________                         __________________________________________________________
Phone _________________________            E-mail address ______________________
Membership dues are $10.00 annually.  Mail completed application and check payable to W.W.C of I.C.C.
Send to:    Sandy Gravseth, Treasurer                 W.W.C. of I.C.C.                 PO Box 3494                 Kent, WA  98032
Questions contact Sandy Gravseth at (253) 798-7112  or  Allen Johannessen at (206) 433-7163