Membership Form – New and Renewal

04/11/2000

LCWA MEMBERSHIP FORM                                                                  Click here for a Printable version

Name: ______________________________________________
Email: ______________________________________________

Summer Mailing Address:
___________________________

___________________________

___________________________

___________________________

Phone:______________________

 

Winter Mailing Address (if different-indicate what months):

___________________________

___________________________

___________________________

___________________________

Phone:______________________

 

Cottage Name: ___________________________________________________

[  ] Individual Membership ($30) [  ] Family Membership ($40)

Please mail with your check to:

Lake Carey Welfare Association—Memberships, P O Box 637, Tunkhannock, PA 18657
 
 
   Click here for a Printable version
 
 
 

Lake Carey Welfare Association, P O Box 637, Tunkhannock, PA 18657