Golden Lake Property Owners Association

P.O. Box 99,

Golden Lake, Ontario

K0J 1X0

www.goldenlake.info

Membership Form

Annual membership fee is $20.00, a portion of which covers the levy for membership in the Federation of Ontario Cottagers’ Association (FOCA)

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: ____________

Please be sure to submit complete information to ensure accurate records by the

Association. Be advised that GLPOA respects the privacy of your information and will not, in any way, divulge personal data to a third party.