MEMBERSHIP FORM
We do not share our membership database with any individual or organization.
PLEASE PRINT CLEARLY.
Permanent or Mailing Address:
Name: __________________________________________________________________________________
Street: ________________________________________________________________ Apt/Box: _________
City: ______________________________________________________ Province/State: ______________
Country: _______________________________ Postal / ZIP Code:_____________________________
Phone (including area code): ________________________________
Lake Vernon Address: if different from above
Fire Number: __________________ Road Name: _______________________________________________
Phone (including area code): _________________________________________________________________
Primary email address: ______________________________________________________________________
You will receive our quarterly Newsletter as well as News Flashes by email.
___Yes, I would like to receive information from the Lake Vernon Association.
Would you like information about the Lake Vernon Association bulk purchase rate for propane from either Moore Propane or Superior Propane?
___Yes, I would like information about the Lake Vernon Associate Propane Program.
Are you interested in volunteering with the Association?
___Yes, I would like to learn more about participating as a volunteer in Association activities.
Annual LVA Membership $ 45.00
Lake Vernon Environmental Association Donation: $__________
The LVEA Fund is a reserve to support Association initiatives. These funds ensure financing is readily available
for important projects such as The Lake Plan. Contributions are tax deductible. Cheques must be made payable to
" Lake Vernon Environmental Association" - contributions are tax deductible.
PLEASE DROP OFF THIS COMPLETED FORM AND YOUR CHEQUE(S) TO RUTHVEN MARINE DURING THEIR BUSINESS HOURS. MEMBERSHIP CHEQUES ARE MADE OUT TO LAKE VERNON ASSOCIATION.
We do not share our membership database with any individual or organization.
PLEASE PRINT CLEARLY.
Permanent or Mailing Address:
Name: __________________________________________________________________________________
Street: ________________________________________________________________ Apt/Box: _________
City: ______________________________________________________ Province/State: ______________
Country: _______________________________ Postal / ZIP Code:_____________________________
Phone (including area code): ________________________________
Lake Vernon Address: if different from above
Fire Number: __________________ Road Name: _______________________________________________
Phone (including area code): _________________________________________________________________
Primary email address: ______________________________________________________________________
You will receive our quarterly Newsletter as well as News Flashes by email.
___Yes, I would like to receive information from the Lake Vernon Association.
Would you like information about the Lake Vernon Association bulk purchase rate for propane from either Moore Propane or Superior Propane?
___Yes, I would like information about the Lake Vernon Associate Propane Program.
Are you interested in volunteering with the Association?
___Yes, I would like to learn more about participating as a volunteer in Association activities.
Annual LVA Membership $ 45.00
Lake Vernon Environmental Association Donation: $__________
The LVEA Fund is a reserve to support Association initiatives. These funds ensure financing is readily available
for important projects such as The Lake Plan. Contributions are tax deductible. Cheques must be made payable to
" Lake Vernon Environmental Association" - contributions are tax deductible.
PLEASE DROP OFF THIS COMPLETED FORM AND YOUR CHEQUE(S) TO RUTHVEN MARINE DURING THEIR BUSINESS HOURS. MEMBERSHIP CHEQUES ARE MADE OUT TO LAKE VERNON ASSOCIATION.
