Membership Application / Payment – Lakes Preservation League

Membership Application / Payment

"*" indicates required fields

First Name*

Last Name*

Renewal / New*

Renewal

New Member

Changes to addresses, phone or e-mail?*

Yes

No

Phone*

Email*

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Lake Address*

Street Address Address Line 2 City State ZIP Code

What information do you need to update? Select all that apply.*

Phone

E-Mail

Mailing Address

Lake Address

Phone*

Email*

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Lake Address*

Street Address Address Line 2 City State ZIP Code

LPL Newsletter Delivery*

LPL Membership ($25.00)*

Optional – Riparian Subscription ($10.00)

Donation – Christmas Baskets

Donation – Water Quality Projects

Total

Payment Method