Print and mail completed Application to address at bottom of form with your membership fee.

Remember that numbers count, so please consider all members of your household when joining

 

Membership Application

Friends of Istokpoga

Lake Association, Inc.

Annual membership fee $7.00 per person

Annual Family Membership fee $12.00 per family*

Annual Associate membership fee $25.00

Annual dues are valid Jan. 1 to Dec. 31

*Family Membership is for a couple and their children under 18 years old living at home

 

Name(s) or Business name___________________________________________________________

1st Street Address___________________________________________________________________

City____________________________________________State_________Zip__________________

Phone (_____) ______-_____________________________

 

2nd Street Address___________________________________________________________________

City____________________________________________State_________Zip__________________

Send all mail to address 1 ___ 2 ___ other ______________________________________________

Phone:(_______) _______-__________________________

E-mail address_____________________________________________________________________

 

Circle Correct Answer

                                       Yes/No    I am willing to work on a committee below?

Committees: Finance, Legislative, Newsletter, Membership, Publicity, Weed Control (Circle one)

             

Associate Member

Is business name EXACTLY as you would have it appear in the newsletter? _______________

Primary Contact____________________________________________________________________

Description of Business _______________________________________________________

___________________________________________________________________________

Web Address______________________________________________________________________

Fax Number (________) _____________________________________________________________

 

                                                Signature:____________________________________________

 

Additionally, I would like to donate $10___$15___$25___other_______

All Donations are tax deductible

 

Make Checks Payable to: Friends of Istokpoga

Mail to: P.O. Box 205, Lorida, FL 33857

 

For additional information call:  863-219-0082 - Voice Mail

friends@istokpoga.org

www.istokpoga.org