Lighthouse Chapter #3235
 

 

Lighthouse H.O.G would like to publish
your birth date in the monthly newsletter
and help you make your day special.

Come to the monthly meeting the month
of our birthday and you get in for free!

Complete and submit the form below.
 
 

 
*First Name:

  
*Last Name:

 
*Birthdate (ex: March, 5)

 		  
 

 

* = Required Field