COLA Membership Application

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COLA Membership Application

Return to: COLA, PO Box 702, Hayward, WI 54843

Name(s):_______________________________________________________________

_______________________________________________________________ email:_________________________________________________________________

Note: email addresses help us reduce postal costs and contact members about timely issues. We guard your email address very carefully and do not share our email list.

Primary residence:_______________________________________________________

City/State/Zip:___________________________________________________________

Phone:________________________________________________________________

Address on the Lake: _____________________________________________________

City/State/Zip:___________________________________________________________

Phone:________________________________________________________________

____ Enclosed are my $25.00 annual dues for 2014

____ Enclosed are my $50.00 annual dues for 2014 and 2015

If you wish to make an additional contribution to COLA, please send to:

Lac Courte Oreilles Foundation, Inc.

Richard Land, Trustee

6756N Victory Heights Circle

Stone Lake, WI 54876-3054

COLA is a 501(c)3 nonprofit organization supported by membership dues, grants, donations and the Lac Courte Oreilles Foundation, Inc.

Lac Courte Oreilles Foundation (LCOF) is a 501(c)3 nonprofit organization assisting COLA protect water quality and property values of lakefront property. Contributions to LCOF are tax deductible.

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