AIS_Course_Completion

LSA Aquatic Invasive Species Education and Awareness Course
Household Member 1*

First NameLast Name
Household Member 2

First NameLast Name
Lot Number*
Phone*
Email*
example@example.com
By signing this form / acknowledge that / have reviewed and completed all material associated with the LSA Aquatic Invasive Species Education and Awareness Course, and also understand and acknowledge all rules and guidelines defined by LSA associated with watercraft entry and cleaning as a partner in preventing the introduction of any Aquatic Invasive Species into Lake Summerset.
Signature*

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Date*

MonthDayYear
Date
(Return to LSA Main Office once completed)
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