Make your own free website on Tripod.com
League of United Latin American Citizens
Merrillville Council 5009 Membership Application



I, the undersigned, hereby most respectfully request membership in the League of United Latin American Citizens Merrillville Council 5009 and state that I will wholeheartedly subscribe to your aims, purposes, code, and Constitution

Note: Items in * bold are required.



* Current Date:

* Applicant Name:

* Home Address:

* City:

* State:

* Zip Code:

* Home Telephone:

E-Mail:

Work Address:

Work City:

Work State:

Work Zip Code:

Work Telephone:

* Signature:



We, the undersigned members in good standing of LULAC, certify that we personally are aquainted with the above applicant and, to the best of our knowledge and belief, this person is of good moral character and worthy of membership in LULAC Merrillville Council 5009.

Member:

Member:



For membership, please complete, print, and sign this form and send it with a payment of $1.00 per month through end of the year, plus a one time $4.00 new member fee to:

LULAC Council 5009
P.O. Box 11154
Merrillville, Indiana 46411



Send an E-Mail to Merrillville LULAC Council 5009.
Go to Merrillville Council 5009 Main Page.