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 bring check or cash to the Annual Meeting, 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
Cellular Number
Camp Number
Camp Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Attending the Annual Breakfast Meeting?
How Many attending? Breakfast. Non-members $20. Children under 12 $10.
I will not be attending the Annual Meeting, I hereby designate Helen Glass, ILA Secretary as my proxy for all matters that come before the board.
Last Name
Signature

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

$10.00 Quantity

Total

$0.00

ILA Membership Application