Membership Form

Membership Form

Membership is open to any individual, family, business, or organization that lives on or within one mile of Birch Island Lake.

Dues are $25 per household each year. Please consider a donation to the Water Quality Committee.

Please complete the form below to JOIN or UPDATE your contact information.

Membership Status(Required)

New Member

Renewing Member

Name

First Last

Phone

Name 2

First Last

Email 2

Phone 2

Birch Island Lake Address:

Street Address City State / Province / Region ZIP / Postal Code

Home Address:

Street Address City State / Province / Region ZIP / Postal Code

Note: All correspondence will be by email, unless there is no email provided.