[SLG logo]Welcome to
Shining Lakes Grove, ADF

Shining Lakes Grove, ADF
P.O. Box 3901
Ann Arbor, MI 48106
734-277-1897
robh@shininglakes.org

Membership Form

 

One form per person, please.

 

 

Legal Name: ___________________________________________________________ P C

 

 

Religious Name (optional): ____________________________________________ P C

 

 

Address: ______________________________________________________________ P C

 

 

City: ______________________________________________ State: ___________ P C

 

 

ZIP Code: __________________ Phone: ___________________________________ P C

 

 

E-Mail Address: _______________________ P C Birthdate: ________________ P C

 

 

In the column next to your personal information, please indicate whether the information is Publishable (P), or Confidential (C). Publishable information will be pritned in the annual Membership Directory. Confidential information will only be shared with members of the Leadership Council.

 

Please check one of the following:

___ New Membership ___ Revival of expired membership ___ Renewal of current membership ___ Name/address change (prior name/zip) ________________________________________________

 

 

SLG Membership and Donation Categories:

SLG Local Membership (see rate table below): =      $ ______
SLG General Fund donation                           $ ______
SLG Land Fund donation                              $ ______
Total enclosed                                      $ ______

Note: To be a full member of Shining Lakes Grove you must also join ADF. Only full members age 18 and up are eligible to hold office and vote. For ADF membership, see the ADF web site (www.adf.org).

 

All SLG memberships expire on November 1st.  Full year membership rates are:
Adult (age 18+): $24 per year
Youth (age 13 - 17): $12 per year
Junior (age 7 - 12): $6 per year
Child (age 1 - 6): $6 per year
Members joining at other times of year pay a prorated membership rate:

If you join in:

Adult (age 18+)

Youth (age 13 - 17)

Junior (age 7 - 12)

Child (age 1 - 6)

November

$24.00

$12.00

$6.00

$6.00

December

$22.00

$11.00

$5.50

$5.50

January

$20.00

$10.00

$5.00

$5.00

February

$18.00

$9.00

$4.50

$4.50

March

$16.00

$8.00

$4.00

$4.00

April

$14.00

$7.00

$3.50

$3.50

May

$12.00

$6.00

$3.00

$3.00

June

$10.00

$5.00

$2.50

$2.50

July

$8.00

$4.00

$2.00

$2.00

August

$6.00

$3.00

$1.50

$1.50

September

$4.00

$2.00

$1.00

$1.00

October

$2.00

$1.00

$0.50

$0.50

 

Waiver: Required for Youth Members who have no member parent/guardian.

To whom it may concern: __________________________________ has my
                             (enter child's name here)
permission to become a member of Shining Lakes Grove, ADF, and I am
fully aware of the neopagan nature of this organization.
Parent's Signature      __________________________________________
Parent's Name (printed) __________________________________________
Notary Signature        __________________________________________
License and Expiration  __________________________________________
Date Signed             __________________________________________