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
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___________________________________________________________
City____________________________________________State_________Zip__________________
Phone (_____) ______-_____________________________
City____________________________________________State_________Zip__________________
Send all mail to address 1 ___ 2 ___ other ______________________________________________
Phone:(_______) _______-__________________________
E-mail address_____________________________________________________________________
Yes/No I am willing to work on a committee below?
Committees: Finance, Legislative, Newsletter, Membership, Publicity, Weed Control (Circle one)
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
For additional information
call: 863-219-0082 - Voice Mail
friends@istokpoga.org
www.istokpoga.org