LOUISIANA SHRIMP ASSOCIATION

P. O. Box 1088, Grand Isle, Louisiana 70358
PHONE: (985) 787-3464 FAX: (985) 787-2965
E_Mail: shrimp@mobitel.com
Dean Blanchard, Treasurer


Related Business Membership Form 2003

THIS FORM MAY BE USED TO SEND A DONATION TO THE ASSOCIATION

L.S.A. needs the support of related businesses in order to fulfill the goals of the Association and sustain the commercial shrimp industry of Louisiana and the United States.

By giving a contribution of at least $250.00 or more, you become a Member in Good Standing and are entitled to vote at our General Membership Meeting.

Please print this form, fill it out and make your check or money order payable to: LOUISIANA SHRIMP ASSOCIATION.
Mail To: P.O. Box 1088 Grand Isle, Louisiana 70358

____$250.00 ____$500.00 ____$1000.00 ____OTHER


__FUEL DOCK __ICE HOUSE __HARDWARE STORE __GROCER __BANK __OTHER

PLEASE HELP BY SUPPORTING OUR COMMERCIAL FISHING INDUSTRY!

DATE_____________

NAME:______________________________________________________________

BUSINESS NAME:____________________________________________________

MAILING ADDRESS:__________________________________________________

CITY:___________________STATE:________________ZIP:__________________

PHONE:______________FAX:______________E-MAIL:______________________


LSA THANKS YOU FOR YOUR SUPPORT!


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