Membership Application
print out the form and mail as indicated

Wabedo-Little Boy-Cooper-Rice Lakes Association

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