DATE_________________________
Name____________________________________________________
Mailing Address___________________________________________
City_______________________State________________Zip_______
Phone____________________________________________________
E-mail___________________________________________________
Address
#2_______________________________________________
City
________________State_________________Zip_____________
Phone____________________________________________________
Comments about your pond:__________________________________
_________________________________________________________
Do you want the newsletter electronically Yes______ No______
Policy
Note: The club e-mail roster is used solely for the purpose of intra-club
communication. We do not distribute any information about club members.