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Please print the form below, and mail it to our office.

Dakota Rural Action is a ...

grassroots,

family agriculture,

and conservation group.

DAKOTA RURAL ACTION NEW MEMBERSHIP

NAME______________________________________________VOTING DIST #______________
MAILING ADDRESS___________________________________COUNTY___________________
CITY_____________________________STATE________ZIP_________________
PHONE___________________ FAX__________________ E-Mail________________________

What issues are you most interested in or concerned about?
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

I would like to be a member of Dakota Rural Action to have a
say in the decisions affecting my future in South Dakota.

Here is my membership dues of:
_____$70 Contributing _____$1000 Patron  
_____$35 Household Member _____$500 Sustaining  
_____$25 Individual Member _____$250 Builder  
_____$52 Buck-A-Week _____$100 Steward ___$ Limited Income

 

Please make your check payable to Dakota Rural Action and include it with this form to:

Dakota Rural Action
P.O. Box 549
Brookings, SD 57006
Phone 697-5204 Thank you.