Email Address:

So that we have your correct information, please complete the following:

Your Address Information
Street Address:
Street Address-2:
City:    State: Zip Code +4    (Example: 12345-6789)
Phone Number: Area Code: (include area code): (example, 123-456-7890)
Is this a family membership? (Check if Yes) - - - If yes, please list the full names of your family members:

Confirmation:  In the future, I would like to receive my Lighthouse News by:(Please check your choice)
Electronic Version (email) - Check if Yes
Hard Copy (via US Postal Service) - Check if Yes
Please send me both the electronic version, and a hard copy - Check if Yes

Comments:

Thank you, and thanks for being a member of the Outer Banks Lighthouse Society!

Robert D. DaVia, Membership Chairman, OBLHS
OBLHS, P.O. Box 2141, Winterville, NC 28590-2141