WY-LGA Membership Registration

Type of Member Producer Affiliate Associate
Name on Membership
Contact Person
City / State / Zip City State Zip
Phone - -
Membership Fees:
Producer/Affiliate member: (min $50) / Assoc. member: (min $250)
Corporate or Exclusive Sponshorship:
*Annual membership is July 1 - June 30
For questions regarding membership contact:
Scott Keith, General Manager (307) 259-3274 or scott.keith@wyo.gov

Instructions: WY-LGA offers two options for paying your dues:
1. Complete the form below. Once completed, you can click the print icon located in your web browser or click the "print" button on this form. Mail completed form along with your respective dues to:
WY-LGA, PO Box 51739, Casper, WY 82605.
2. You can fill out the form and press the submit button. The form will be emailed to Scott Keith, WY-LGA General Manager. You will then need to mail your respective dues to the address noted above.
3. For a PDF form - click here.

For questions, please contact Scott Keith at (307) 259-3274 or scott.keith@wyo.gov

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