Please fill complete the following membership form. Once you have clicked on the submit button, an e-mail containing the information you submitted will be sent to LWLA. You will be routed to the Secure Paypal site where you can pay your dues/donation via credit card.

Dues are $10.00 per family annually. The membership period runs from January 1 to December 31. Donations are most welcomed and very much appreciated!

Thank you very much for becoming a LWLA member and for considering an added donation.

Amount being paid:

Name:

Mailing Address:

City

State

Zip Code

Home Phone

Email Address

Lake Street Number

Lake Road

Lake Phone

Do you own this Property?
Yes No

Is this property Co-owned?
No Yes

Name and Address of Co-Owner

I would like to reduce mailing cost by havings coorespondence sent electronically.....

I would like to help keep membership data current by adopting my road.....

I would like to help the association with other projects.....

I would like my donation acknowledged on the web site and in the next newsletter.....