Membership Form

Thank you for joining Leeds Civic Association! The form below will be sent to the LCA treasurer. After you complete the form you will receive an email confirmation with a link to pay online. If you would rather pay by regular mail, please send your payment to:

Leeds Civic Association
PO Box 114
Leeds, MA 01053

Your Name (required)

Your Email (required)

Your Home Address (required)

Your Phone Number

This membership is:  New A Renewal

 $25.00 - *Business Yearly Membership (Please enclose business card) $10.00 - Family Yearly Membership

*Business Membership includes 1 year LCA website advertising

Additional Donation $

I would like my Newsletter delivered:
 By Email Hand Delivered By Mail (Add $ 4.50 for postage to total below)

Total Amount $

 I will pay online I will pay by mail

I would be willing to help with any of the following activities:

 Entertainment Educational (speakers, workshops) Newsletter/flyer production
 Landscaping Projects Fundraising Special projects

Use the space below to explain how you can help:

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