ILA Membership

ILA Membership Application

To apply for membership complete all questions. Please send payment to Treasurer, ILA, PO Box 973 Sabael, NY 12864, or pay via bank ACH transfer (ie Bill Pay). If paying by ACH Transfer, use your first and last name as your account number. Make payments payable to "Indian Lake Association, ADK, Inc." You can also now pay by credit card by completing the credit card information below.
New or renewing membership? (If renewing please complete all info even if you think we have it.)
Name*

First NameLast Name
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
example@example.com
Home Number
Format: (000) 000-0000.
Cellular Number
Format: (000) 000-0000.
Camp Number
Format: (000) 000-0000.
Camp Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I agree to abide by the rules of the Indian Lake Association ADK, Inc., and to receive electronic communications from the Association.
Attending the Annual Breakfast Meeting?
How Many attending? To sign up non-members use sign up sheet.
If I do not attend the Annual Meeting, I hereby designate Helen Glass, ILA Secretary as my proxy for all matters that come before the Membership for a vote.

YesNo
Signature*
Method of Payment
Date

MonthDayYear
Date

Membership Levels

GOLD Membership - 3 Year

$80.00

SILVER Membership - 2 Years

$55.00

BRONZE Membership - 1 year

$30.00

Donations Gladly Accepted & Greatly Appreciated

Please choose your donation amount by choosing quantities in multiples of $10.00

$10.00 Quantity

Total

$0.00

ILA Membership Application