____ Renewal
____ New Membership
Name__________________________________________________________________________________
Address________________________________________________________________________________
City ___________________
State ____ Zip_________ Phone___________ Email:
__________________
____ Individual ($15) ____
Family ($25) ____ Supporting ($100)
_____ Children under 12 ($5)
Life Membership ($500)
I am contributing $________ to the Highlandlake Church
Restoration Project
I would like to
help with:
____ Membership
Committee ____Highlandlake Church ____ Highlandlake Pioneer
Cemetery
____ Educational Outreach
____ Programs & Tours ____ Voices From the Grave
____ Annual
Reunion and Community Gathering _____ Oral History
Project
_____ People of Highlandlake and Mead Photo Project