Membership Renewal/New Application Form
Island Lakes Residents' Group Inc.
October 1,2010 - September 30,2011

For the sum of only $10.00 per year you support development and issues of concern in your own community

Name:_______________________________________

Address: _______________________________________

Postal Code:____________ 

Phone No: _______________

Click on the small printer icon below, fill out the form and return this membership form
along with your $10.00 to 91 Charbonneau,  35 Breakwater Cove, or Island Lakes Pharmacy located in out local mall.