Please check the appropriate boxes and complete the form by typing the informing in the boxes. When completed the form can be printed by going to your web browser menu at the top of the page. Click on File a drop down menu will appear, select print and than ok. The form will print with the information your have completed. Mail completed form and check to to LITPC Treasurer or click the PayPal button and pay your dues. Follow the instruction on the screen. Email the completed form to the LITPC Treasurer.

New Renewal Change in Data

Name Spouse Year Joined 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Trade by Mail No Yes

Address Member Lion Lioness Leo Office None VDG DG CC PDG PCC ID PID IP PIP MJF No Yes

City State/Province Zip Code Country

Res Phone Bus Phone Sponsor

Email Address Lions Club Multiple District Sub-District

Send LITPC "Trading Post" via email No Yes

Dues are $15.00 US per year and MUST be paid in US Dollars. You may pay multiple years, if desired. Dues are due and payable by July 31 of each year for the ensuing year.