Membership/Donation Form

Print out this form (or simply jot down the information)
and make check out to "LSLK."

Send to:
Losel Shedrup Ling of Knoxville
5415F Kingston Pike Knoxville, TN 37919

I would like to (Check one or both):
__ Join LSLK
__ Make a donation to LSLK

If you would like to become a member, choose a category:
__ Regular ($25/month)
__ Student ($15/month)
__ Senior ($15/month)
__ Family ($35/month)

If you would like to make a donation, enter the amount: $______________