Membership Form – New and Renewal

04/11/2000

LCWA MEMBERSHIP FORM                                                                  Printable embership Form 2022

LCWA MEMBERSHIP FORM

Name: ______________________________________________

Email: ______________________________________________

 

Summer Mailing Address:

______________________________________________________________________

(Street)     (City)         (State)      (Zip)          (Phone)

 

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

______________________________________________________________________

(Street)     (City)         (State)      (Zip)          (Phone)

 

Cottage Name:  ___________________________________________________

 

 

Please mail with your check to:

Individual / Family Membership ($50)

Lake Carey Welfare Association—Memberships, PO Box 637, Tunkhannock, PA  18657

THANK YOU FOR YOUR SUPPORT!

 
 

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