Membership Application Form

Address

E-mail
Home Number

Area Code Phone Number
Individual Level of Membership

Student (HS/College) - $10 Friend - $25 Family - $50 Partner - $125 Supporter - $200 Donation only
Enter the message as it's shown *
Submit form and mail check,
payable to FTLSP:
FTLSP, PO Box 493, Taylorsville, KY 40071
Should be Empty: