P. O. Box 273
                            HARRISVILLE, N.Y. 13648

                      

                    

APPLICATION FOR MEMBERSHIP OR

CHANGE E-MAIL ADDRESS

If you would like to become a member of the Lake Bonaparte Conservation Club, please complete the form below and a membership application will be mailed to you. Dues is $12 per year for a single membership, $15 for a married couple with no children, and $20 a year for a family (husband, wife, and all children under the age of 18). Whenever a new issue of the Newsletter, information about the milfoil program, or any item of general interest to the Lake Bonaparte community is posted to the web site, we notify all members by e-mail. Also, if you change your e-mail address or mailing address, use the form to notify us. Our list is confidential and will not be sold or given to anyone. You may have your name removed from the list at anytime by sending us an e-mail at lakebonaparte@wildblue.net

Please provide the following contact information:

First Name

Last Name

Street Address

   

City

State/Province

Zip/Postal Code

   

E-mail

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Copyright © 2004 [Lake Bonaparte Conservation Club, Inc]. All rights reserved.
Revised: 09/10/08