Preserve Lake Dunlap Association

2010 Membership Registration Form

PLEASE PRINT

NAME:
Last:  ___________________________________ First: ______________________
Spouse:  __________________________________

LAKE DUNLAP ADDRESS:
Street: _________________________________________________________
City: _______________________________ State:  ______   Zip  ___________

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

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

EMAIL ADDRESS:  _______________________________________

IMPORTANT NOTE: Please also add your email address to our list by clicking the top box on our website http://www.plda.org/.

DUES: $40  ________  Seniors  $25  ________

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

FLAGS:  Gold Flag $200 _____ Silver Flag $100  _____ Bronze Flag $75  _____

NOTE: Flags will be shipped immediately.

TOTAL AMOUNT ENCLOSED: $ ____________

Please mail this form and your check for dues and flags to:

PRESERVE LAKE DUNLAP ASSOCIATION
PO BOX 312448
New Braunfels TX 78131

Please feel free to contact us with any questions or comments.

Email: plda@plda.org Website: http://www.plda.org/

Thank you very much for your interest and support.