print out the form and mail as indicated

 

 

Name:_______________________________________________
            Last                     First                     Spouse

Lake:__________________

Lake address:_________________________________________
                    Street

_____________________________________________________
City State Zip

Lake phone #:_________________________________________

Permanent address:____________________________________
                            Street

____________________________________________________
City State Zip

Phone #:_____________________________________________

Date:__________________

Email:________________________

Dues	Regular Member	$20		AIS Prevention/ Treatment Fund	$20
	Contributing Member	$40			$40
	Sustaining Member	$60			$60
	Benefactor	$100			$100
	Associate(non-voting)	$25			$_____

(circle amount for both Dues and AIS categories)

Send to:

WLBCR Lakes Assoc, P.O. Box 133, Longville, MN 56655