Hadeland Lag - Membership Application

Member Information

      Name _____________________________________________________________________

   Mailing Address __________________________________________________________

   City  _________________________________________  State/Province __________

   Zip/Postal Code _________________       Home Phone _______________________

   E-mail ____________________________________________ 

   If you would like to have a user id & password for the members only area

     of the website, check here ____.  Once your application is processed,

     they will be sent to the email address listed above. 

   A list of member names & email addresses is kept in the members only area of the

     website.  If you do not want to appear on this list, check here___.

  Hadeland Family Connection 

    Brief Statement indicating your interest/connection to Hadeland

  ___________________________________________________________________________________

  ___________________________________________________________________________________

  ___________________________________________________________________________________

   Provide any of the following information you know:

How Did You Hear About the Hadeland Lag?

(Select only one, please)

__ Friend/Family Member               __ An Event 

__ Another Lag                        __ Print Ad/Article

__ The Internet                       __ TV/Radio         

__ Other

Comment (if you selected 'other' above, please explain)

 _____________________________________________________________________________________________

Instructions

Print the application and fill it out.

Mail it with your check (made out to Hadeland Lag) for the desired membership period.