Lake
Madison Development Association
P.O. Box 296
Madison SD 57042-0296
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MEMBERSHIP FORM 2009 Membership Dues $25.00 |
Name of person(s) to be listed in Directory: ______________________________________________________________________________
Mailing Address: (Street Address)____________________________________________________________________
(City)___________________________________________, (State)__________(Zip Code)___________
Phone number for directory (optional): (_________) ________________________________
E-Mail Address (optional but please print clearly): ____________________________________________________________________________
Please consider a voluntary contribution of
$25.00 or more for the Water Quality Improvement Fund.
____Yes enclosed ____No thank you
____Dues $25.00
____Water Quality Contribution __________
Total Enclosed: $_________________
Please make check payable to the Lake Madison Development Association and mail to the address at the top of the form. Thank you.