To join the Miller Lake Community Group, please print this page, fill in the details and mail to:
Randy Gulliver, 45 Hastings Ave., Toronto, ON, M4L 2L1.

Yes I/we would like to become a member of the Miller Lake Community Group and have our voice heard.
Enclosed, please find my cheque for $20.00 family membership.
Make cheque payable to Miller Lake Community Group.

Date:_________________

Name:_______________________________________________________

Mailing Address:____________________________________________________

City:______________________

Province/State:_____________________ Postal/Zip Code:________________

Phone #:____________________________

E-mail Address:_________________________________________________________

( ) Please keep me informed of Association matters by E-mail.

A concern I wish to discuss or have addressed is:

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Privacy Note: MLCG does not share any personal information with any other organizations.