New Member/Update Member Form

Name*

First Last

Spouse/Partner

First Last

Lake Property Address*

Street Address City State ZIP Code

Other Addresses

My summer address is different than my lake property address

My winter address is different than my lake property address

Summer Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Winter Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Primary Phone*

Secondary Phone

Primary Email*

Secondary Email

Go Green – Receiving Your Newsletters by Email*

Both the Newsletter and the eNews are always available on the DLIA website.

Yes

Zone Number (if known)

Zone Representative (if known)

Membership*

Annual Dues are $25.

New Member - will pay my dues online

New Member - will pay my dues by mail

Existing Member - update my information only

Existing Member - update my information and pay my dues

Yearly Dues*

Price: $25.00

Processing Fee

Price: $0.00

Total

Comments

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Comments

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