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                                     Name_______________________________________________________

 

                                       (Last, First, and Middle Initial)

 

 

                            ☐     New member - please fill out entire form

 

                            ☐     Return member - please note changes only

                          

                            Mailing Address_____________________________________________  

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                            City, State, Zip_______________________________________________

 

                            Home Telephone____________________________________________

 

                            Cell Phone__________________________________________________

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                            E-mail Address______________________________________________

 

                            Comments_________________________________________________

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                            _____________________________________________________________

                           

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Annual dues shall be $30 preferably paid on or before April 1st of the calendar year.

 

Please make checks payable to

Garden Club of Lake Placid

and mail to:

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Garden Club of Lake Placid

Post Office Box 984

Lake Placid, NY 12946

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   01/01/24