Mail application and dues to:  
Keeler Lake Property Owners Association
60444 Walnut Drive
Decatur, Michigan 49045
Your 2002 KLPOA dues of $15.00 are due by June 1, 2002.

Please fill out the information below and return with your payment:

     Name: _______________________________________________________________________________       Lot #: _________________
                  
     Lake Address: ______________________________________________________________________       Lake Phone #: _______________________________
     Out-of-State Address: _____________________________________________________________       Out-of-State Phone #: ______________________

(street)

                                           _____________________________________________________________     

(city, state, zip)

Emergency Contact (someone at a different address/phone, not your spouse):

     Name: _________________________________________________________________________________ 

Phone #: ___________________________________

Email Address: ________________________________________________________________________________