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Membership Application

Lutz Civic Association, Inc. Membership Application

Membership as a voting member is open to anyone living in or owning a business in the Lutz Civic Association (LCA) defined boundaries of Lutz. All others are invited as an “Associate” member. Membership is subject to approval and includes a monthly newsletter.

Membership Application Document

Forward your completed application and payment to: Lutz Civic Association, Inc., P.O. Box 1, Lutz, FL 33548.

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Date: _______________________________________

Name(s): ______________________________________

Address: ____________________________________

City / State / Zip: ______________________________

Home Phone: _________________________________

Business Phone: ______________________________

Cell Phone:___________________________________

E-mail Address: ________________________________

Signature: ____________________________________

Type of Membership
(Check One)

( ) Single Member = $15.00

( ) Family Member = $20.00 (2 members, same home)

( ) Business Member = $25.00
 
( ) Civic Member = $10.00 (non-profit organization, 1 vote)

( ) Associate Member = $15.00 (non-voting status)

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