You can either print this page or print the the Microsoft Word version of the membership form. Please send your form and payment to the address below. For more information, please contact your nearest Association Director or Zone Representative.

 

Membership Form

Name:_______________________________________________________

Home mailing address: _________________________________________

________________________ Code: ___________

Golden Lake 911 address: _______________________________________

_________________________Code: __________

Telephone: (home)         _________________________

(cottage)         _________________________

Email(s): _______________________  ________________________

Cottage Watch – Please indicate if you are interested in registering for this

Crime Prevention Program      Yes ________    No ________

GLPOA Zone (1-10):  ____  Zone Director: _____________________

Membership Card Number: ________________

Paid to: ____________________________  Date: ________________

Treasurer’s receipt: ___________                     Registrar: ____________