FOR MORE INFORMATION ABOUT BECOMING

A MEMBER OF THE

"BURBANK NOON LIONS"

COMPLETE THE FOLLOWING AND MAIL TO:

Burbank Noon Lions

P.O. Box 1424

Burbank, CA 91505

I am interested in becoming a member of the Burbank Noon Lions, please contact me.

(Please print in black ink)

Daytime Phone:___________________  Evening:___________________________

Bus/Profession:_______________________________________________

Co. Name:___________________________________________________

Your Name:__________________________________________________

Mailing Address:______________________________________________

City, State, Zip: _______________________________________________