Preserve Lake Dunlap Association

2008 Membership Registration Form

PLEASE PRINT

NAME:
Last:  _________________________________________________________ 
First: __________________________________________________________ 
Spouse:  _______________________________________________________

MAILING ADDRESS:
Street: _________________________________________________________
City: _______________________________  State:  ______  Zip  ___________

LAKE DUNLAP ADDRESS (If different from above):
Street: _________________________________________________________
City: _______________________________  State:  ______  Zip  ___________

TEL # (Please include area codes):
Home:  _________________________Cell:  __________________
Work:  ________________________  Other:  ________________  
Email Address:  _______________________________________

DUES: $50  ________  Seniors  $40  ________

Members who have paid their annual dues are eligible to purchase PLDA flags.

FLAGS:  Gold Flag $200  ________  Silver Flag $100  ________  Bronze Flag $50  ________
TOTAL AMOUNT ENCLOSED: $ ____________

Please mail this form and your check for dues and flags to:
PLDA
PO BOX 312448
New Braunfels TX 78131

NOTE: Flags will be ship immediately.