Yes, I Support the Constitutional Rights of Private Property Owners.

Date: __________________

Individual and Family Memberships ($20.00) : Donation Amount: _____________

Last Name: ______________________ First: ________________________ MI: ___

Street: _______________________________________________________________

City: _________________________ State: ________________ Zip: _____________

Phone: _________________________________ Fax: _________________________

E-mail: ______________________________________________________________

Please make checks payable to Minnesota Landowner's Rights Association. Send form, payment, and donations to:

Minnesota Landowner's Rights Association

Route 2, Box 75

Gatzke, MN 56724