ASSOCIATE MEMBER: (adult Membership ...........................$10.00)
                                        (Student 23 or under...........................$5.00)

Name..............
Street Address
City State Zip
Phone Email
“I do not have internet access, please mail LS Lite.”
Club Name

Let the Council Know of your areas of Interest

Giving this information will not obligate you to actively participate in Council activities, but will give the Council a base from which to invite participation.

Please put a check box in front of any and all areas of interest. Check two boxs in any area of interest on which you wish to be called to participate in council activities.

Please print and mail to Lorraine Biner, 13054 Apple Road, Wilton, CA 95693 or cut and paste form into email and email to Lorraine Biner.