Name__________________________________________________

 

 

                                         (Last, First, and Middle Initial)

 

 

                            ☐     New member - please fill out entire form

 

                            ☐     Return member - please note changes only

                          

                            Mailing Address_________________________________________   

 

                            City, State, Zip___________________________________________

 

                            Home Telephone_________________________________________

 

                            Cell Phone______________________________________________

 

                            E-mail Address__________________________________________

    Any Comments__________________________________________

    _______________________________________________________

    _______________________________________________________

                           

 

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:

 

Garden Club of Lake Placid

Post Office Box 984

Lake Placid, NY 12946 

 

©2019 Garden Club of Lake Placid

 

REGISTRATION FORM