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Membership is open and FREE to individuals or groups residing in the watershed. La Moine River Ecosystem Partnership
Application For Membership
____ Yes I want to join the La Moine River
Ecosystem Partnership as:
(please check one)
____ Individual member
____ Organization Membership
Organization Name
_______________________________________________
Declared County ______________________________ Contact Information:
Name: ________________________________________________
Address: ______________________________________________
City, State, Zip: _________________________________________
Phone: day __________________ evening ___________________
e-mail: ___________________________ fax: _________________ Please return
this form to:
La Moine River Ecosystem Partnership
C/o Two Rivers RC&D
110 E. Fayett St.
Pittsfield, IL 62362
If you have questions, please call 217-285-4114 | 
