Membership Renewal/New Application Form
Island Lakes Residents' Group Inc.
October 1,2008 - September 30,2009

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: _______________

Please return this membership form along with your $10.00 to 91 Charbonneau, 15 Island Cove, 35 Breakwater Cove, or Island Lakes Pharmacy located in out local mall.