THE LAKE MICHIGAN CARDIGAN CLUB
ANNUAL DUES NOTICE

DUES ARE DUE ON OR BEFORE AUGUST 31, 20____.

MEMBERšS NAME(S): ______________________________________________________________

CHANGE OF ADDRESS?	___ YES	___ NO
ANY OTHER CHANGES? (CHECK ANY THAT APPLY):   ___ PHONE   ___ E-MAIL   ___ WEBSITE

NEW INFORMATION IF APPLICABLE:
ADDRESS:	_______________________________________________________________________
___________________________________________________________________________________
CITY_______________________________________________  STATE _________  ZIP___________
PHONE: (______)_______________________
E-MAIL:____________________________________________
WEBSITE:___________________________________________________________________________

MEMBERSHIP OPTIONS (CHECK ONE):

	___ $15.00	REGULAR HOUSEHOLD VOTING MEMBERSHIP
	___ $10.00	REGULAR SINGLE VOTING MEMBERSHIP
	___ $ 5.00	REGULAR JUNIOR (10-17 YEARS) MEMBERSHIP
	___ $7.50	ASSOCIATE HOUSEHOLD NON-VOTING MEMBERSHIP
	___ $ 5.00	ASSOCIATE SINGLE NON-VOTING MEMBERSHIP
	___ $ 2.50	ASSOCIATE JUNIOR (10-17 YEARS) MEMBERSHIP

Please make Check or Money Order payable to: LYNN GRINER
Due to a change in policy at the bank, checks or money orders made out to LMCC will not be accepted by the bank.

PLEASE RETURN THIS FORM WITH RENEWAL DUES TO:

Lynn Griner, LMCC Treausrer
7532 East W Ave
Vicksburg, MI 49097
(269) 649-0758

DUES NOT RECEIVED BEFORE OCTOBER 31 OF RENEWAL YEAR WILL RESULT IN MEMBERSHIP LAPSE.