LCIA Membership form

Lake Cavanaugh Membership Form
In order to maintain an accurate database, the LCIA asks our community members to keep their information up to date! In addition to paying annual LCIA dues, please complete the form below so we can make updates to the LCIA membership database.

For dues payments, you can pay via PayPal via http://www.lakecavanaugh.info/committees-clubs/paypal/ or write a check. Checks can made out to LCIA and mailed to 35022 South Shore Drive, Mount Vernon, WA 98274-9362. If you choose to pay cash, please do so in-person at a LCIA meeting.

* Required
First Name(s) *
Please include your spouse/partner's name, if applicable.
Your answer
Last Name *
If there are different last names, please list in order of the corresponding First Names.
Your answer
Home Phone
Please include the phone number of your primary residence.
Your answer
Home Street Address
This is in reference to your primary home address. If Lake Cavanaugh is your primary residence, please skip this question.
Your answer
Home City
This is in reference to your primary home address.
Your answer
Home State
This is in reference to your primary home address.
Your answer
Home Zip Code
This is in reference to your primary home address.
Your answer
Primary Email Address *
This email address will be your Lake Cavanaugh website login username.
Your answer
Secondary Email Address
If applicable, you can include an additional email address.
Your answer
Cell Phone #1
You may provide two additional phone numbers.
Your answer
Cell Phone #2
You may provide two additional phone numbers.
Your answer
Lake Cavanaugh Address *
Please include the street address of your Lake Cavanaugh home.
Your answer
Lake Phone Number *
Please include the phone number of your Lake Cavanaugh residence.
Your answer
Cabin Name
If your Lake Cavanaugh home has a name, please include that here!
Your answer
Residency Information *
Please indicate which of the following describes you best:
Owner Type *
Per LCIA bylaws, only the primary owner of a property can be its voting member. To keep track of the members and families, we have included the following options. Please select one:
Membership Type *
Please select from the following membership types. Instructions for dues payments will be included at the end of this form, and you will need to pay via PayPal, check, or cash.
Recent Membership Payment
If applicable, please indicate the most recent date you paid dues. You can include a future date if you intend to pay dues. This information allows us to validate the information in the database.
MM
/
DD
/
YYYY
LCIA Directory Information *
The LCIA Directory is updated every three years and distributed to dues-paying members. For information on when the next Directory will be printed, please contact a member of the LCIA Board (http://www.lakecavanaugh.info/contacts/). All residents will be listed with their lake address and lake phone number, hometown (city, state), cell phone number, and email addresses (when listed). Please indicate what additional information you would like included in the Directory.
Required
Would you like a copy of the LCIA Directory? *
Directories are printed every 3 years.
Choose
Yes - Please mail to my home address
Yes - Please mail to my lake address
No - I do not want the Lake Cavanaugh Directory
How would you like to receive the Lake Cavanaugh newsletters? *
Each Lake Cavanaugh resident receives one newsletter per year, while full and associate members receive a quarterly newsletter.
Required
Would you like to be included on the email distribution list? *
This applies to the primary email only. You will receive LCIA updates and newsletters and can unsubscribe at any time.
Choose
Yes
No
Name(s) of Family Members
If you would like to include the name(s) of people in your family, you may do so here.
Your answer
Notes, Questions or Comments for the LCIA Board
If you have anything to share with the LCIA Board, please include them here!
Your answer
Submit
Page 1 of 1
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service
 
 

 

Comments are closed