LIPC

Long Island Planning Council

Please print this application, fill it out, and mail it with your dues.

Dues are $25 per year and are tax-deductible.

Thank you for your support!

Name:

Street:

City, State, Zip:

Phone Number:

Please make check payable to:

LIPC

PO Box 192

Wantagh, NY 11793

Revision Date: 2004-09-10