Winnebago Eastshore Conservation Club

W4752 Hickory Hills Rd
Chilton, WI 53014

ph: 920-439-1686

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Form for Written Notice of Infractions

WECC Written Notice of Threats, Abusive Behavior & Infractions of Club Rules

Date:__________

Time:__________

Name of Offender:__________________________________________________________

Description of Person:________________________________________________________

Description of Vehicle:________________________________________________________

Name of Person Reporting Offense:_____________________________________________

Offense:_____________________________________________

 ____________________________________________________

____________________________________________________

____________________________________________________

____________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Brought to WECC Board of Directors on:____________________________

Written Notice Sent:____________________________________________

Offense #:_________________








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W4752 Hickory Hills Rd
Chilton, WI 53014

ph: 920-439-1686