BERLIN LAKE ASSOCIATION

Membership Application



NAME__________________________________ Date__________

Home Address___________________________________________

City____________________State_______Zip_________

Lake Address____________________________________________

City_____________________Zip___________________

PHONE (home)_____________ (lake)________________

Occupation______________ EMAIL__________________________


How do you use the lake? boating_____, fishing_____,

Other_________________

Your main issues/concerns_________________________________

______________________________________________________________________________________________________________

_______________________________________________________


Are you interested in contributing time to the association? If yes, please check those that apply

Committee member_____, Officer_________

Service volunteer______, Director_________ Other____________________


COMMENTS_________________________________________________________________________________________________________________________________________________________________________________________________________________


________Enclosed $25.00 membership dues (entitles each household to two voting memberships). Please make checks to: Berlin Lake Association


Return to: Berlin Lake Association

P.O. BOX 54

Deerfield, Ohio 44411


Email: lynne.berlinlake@gmail.com