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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:

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.

NEW! Now pay online. Please still email the above form to our office ( This e-mail address is being protected from spambots. You need JavaScript enabled to view it ).