LAKEVIEW ASSOCIATION OF ALUMNI AND FRIENDS, INC.P. O. Box 206 – Wabash, Arkansas 72389

Membership Form – 2017-2018(Annual Membership = July 1, 2017 through June 30, 2018)

Complete a separate form for each member

Please Print:NAME: __________________________________________________________________ Last First Middle Maiden

ADDRESS: _______________________________________________________________Home # Street City State Zip-Code

Telephone: __________________Cell: _______________E-Mail: ___________________

Membership Information:

Check one: _______ Regular Membership = $25.00, ____ Youth (Age 20 or younger) Membership = $5.00

_______ Alumni (Year of Attendance __________/ Year of Graduation _________ ) = $____________

_______ Friend (Did You Attend? ______ If Yes, Years ___________) = $ ____________

Donation to Association (Please note if for a designated cause)

____General Fund _____ Building Fund _____ Children’s Fund (Book Award/ Back-to-School/ETC.)

______________ Other (_______________________________________________________________________________________)

Donation Total: $ __________________

*********TOTAL AMOUNT PAID********* $_____________________________

Please return this form with your check or money order to the address shown above.

Lakeview Association of Alumni & Friends, a 501 © (3) non-profit organization, has as its mission. To preserve the legacy of the community by establishing, developing and maintaining an educational/economic development center which will provide an array of services for the purpose of improving the quality of life within the community.

BECOME A MEMBER AND HELP THE ASSOCIATION TO FULFILL ITS MISSION.

5/15/2017 (EDITED) VJW