MEMBERSHIP APPLICATION

Last Name:

First Name:

Business Name:

Primary Mailing Address:

City:

State:

Zip Code:

Primary Phone:

Email:

Three Lakes Address:

Three Lakes Phone:

Lake:

Enclosed is my check for $ including $20 for dues
and an additional $ contribution toward preserving

and protecting our waterways, which may be tax deductible.

I would like to receive my TLWA Newsletter by: ______ mail, ______ email, ______ both

Please complete this form on-line, print,
mark choice of newsletter delivery and mail with check payable to:
Three Lakes Waterfront Association, Inc., PO Box 145, Three Lakes, WI 54562
Three Lakes Waterfront Association ~ PO Box 145~ Three Lakes, Wisconsin 54562
Email: Three Lakes Waterfront Association