Enrollment Form – Print & Mail

LEESVILLE LAKE ASSOCIATION

PO BOX 68

ALTAVISTA, VA 24517

NEW MEMBER ENROLLMENT

All Leesville Lake residents, property owners, and lake users are invited to join. We are working on:

  • Lake clean up
  • Mile markers and navigational aids
  • Detailed lake map
  • Safety
  • Water quality and quantity

Your membership goes toward helping accomplish these goals.

Thank you for your help.

______ $25 tax deductible, annual dues (payable to Leesville Lake Association and mail to the above address)

Name_______________________________________________________________________
Address_____________________________________________________________________
____________________________________________________________________________
Phone_______________________________________________________________________
E-mail_______________________________________________________________________
County where lake property located______________________________________________

Preference for receiving quarterly newsletter: Regular mail__________ E-mail________

______ Corrections to information if already a member
____________________________________________________________________________
____________________________________________________________________________

______ Comments: What issues surrounding the lake are of concern to you?
____________________________________________________________________________
____________________________________________________________________________