Membership Information
Louks/Loucks Family Association
Membership Registration/Renewal Form
Your Name: __________________________________________________________________________________
Address: _____________________________________________________________________________________
City: _________________________________ Province/State: __________ Zip/Postal Code: _______________
Phone: ( __________) ___________________________ Email Address: ________________________________
Names of others in family joining and relationship (i.e., spouse, daughter, son, etc.): ___________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Type of Membership Fee & Cost for Each Person
LLFA Annual Membership (two years recommended)
One Year: $10 CDN $9 US
Two Year: $20 CDN $18 US
LLFA Lifetime Membership (10 x the annual membership fee)
Lifetime: $100 CDN $90 US
Grand Total Enclosed $_____________
Please mail this completed form with cheque/check or money order made payable to one of the following,
in Canada, to: Terry Loucks, 760 Chemin Sheldon, Canton de Stanstead, QC J1X 3W4
or in the U.S., to: Ralph E. Louks, 4096 Parsons Walk, Saginaw, MI 48603
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Louks/Loucks Family Association
Reunion Registration Form
Michigan
August (Year to be determined)
Your Name: ___________________________________________________ Special Needs: ______________________________
Address: _______________________________________________________________________________________________________
City: ___________________________________________ Province/State: _____________ Zip/Postal Code: _____________
Phone: ( ) ______________________ Email Address: ______________________________________________________
Names of others in your party, and relationship (i.e., spouse, daughter, son, guest, etc.),
and please note any dietary restrictions: ______________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
NOTE: Please make all lodging accommodations and other reservations on your own.
Registration Fees Adult and Family Rates Quantity Total
Registration Adults: $10 CDN $9 US __________ $__________
(includes Friday reception
& Saturday breakfast) Children under 18: No charge __________ $__________
Other Weekend Meals
(on your own) Grand Total Enclosed $__________
Please mail this completed form with cheque/check or money order made payable to one of the following, in Canada, to: Terry Loucks,
760 Chemin Sheldon, Canton de Stanstead, QC J1X 3W4, or, in the U.S., to: Ralph E. Louks, 4096 Parsons Walk, Saginaw, MI 48603.