Membership Application


                                                             *General Monthly Meeting*
                                                         * Third Thursday of Each Month*
                                                                   *Art Serve at 7 PM*


Please complete and mail this form along with your check to LRCA, Inc. Post Office Box 4506
Fort Lauderdale, Florida 33338, or bring it to the monthly meeting:
Date: ______________
Membership Year: ______________
First & Last Name: _______________________________________________________
Name of Business: _______________________________________________________
(if applicable):
Address: _______________________________________________________
Mailing Address _______________________________________________________
(if different than above): How do you want to be contacted?
Phone: ______________________________________ _________
Cell: ______________________________________ _________
Email: ______________________________________ _________
Lake Ridge Civic Association dues are paid annually. Membership Renewal is January 1 each year.
Please check the appropriate line:
________ $35.00 Residential Homeowner
________ $10.00 Renter
________ $20.00 Senior Citizen (age 62 or older)/Disabled
________ $50.00 Multi Tenant Residential Property Owner or Commercial Business
________ Donation
I am interested in helping with the following committee(s). Mark with an (X):
Membership _____ Green Works _____ Public Safety _____ Street Captain _____ Newsletter _____
Aesthetics_____ Events _____ Monument_____ Traffic____ Dog Walks _____ Events _____
Communications _____ Families & Youth _____ Business Partnerships _____ Other _____
Comments & Suggestions:
www.LakeRidgeCivic.org UNITY IN THE COMMUNITY LakeRidgeCivic@gmail.com