LaGrange County Lakes Council
To promote, protect and preserve the quality of the lakes and watersheds of LaGrange County

Yes, I want to Join:

Name ........................................................................................................................
Mailing address ........................................................................................................................
City, State, Zip ........................................................................................................................
Lake of residence ........................................................................................................................
E-mail address ........................................................@............................................................
Telephone ........................................................................................................................
Your Website URL .........................................................................................................................
Annual Dues $_________
Additional donation $_________
Scholarship Fund donation $_________
Total enclosed $_________
        
Individual/Family $25.00 (Additional donation $____________)
Lake Association $25.00
Business Sponsor $50.00 ($50 is the minimum contribution for Business Sponsors.) 
Suggested Business Sponsor contributions:

   $100.00

(Up to 50 employees)

$200.00

(Up to 100 employees)

$300.00

(Over 100 employees)

All dues contributions are tax-deductible. LCLC is a 501 (c)(3) not-for-profit corporation.

Please mail this form with your check to:

LaGrange County Lakes Council
P.O. Box 86
LaGrange, IN 46761

Reviewed June 2008