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Membership Registration Form

Date:
Name:
Spouse's Name:
Address:
Home Phone:
Work Phone:
Cell Phone:
Fax:
E-mail
Lions Alumni

yes
what year
Membership levels: $33.00
$60.00
$125.00
$250.00
$500.00
Membership total
Additional contributions
Total amount paid

Complete, print, and mail with check to:
Central Gardens of North Iowa
P.O. Box 735
Clear Lake, IA 50425-0735

Checks payable to:
Central Gardens/CL Development Foundation, a 501 (c)(3) non profit organization)

For questions please call: 641.357.1938
or fax to: 641.357.1939
or e-mail to: [email protected]

 

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