Please correct or add any information below. If you do not want something included in the directory please indicate.

Your name:
Year you moved in: 
Local Address (number and street, we know the rest!):
Spouse/Co-Resident Name:
Your phone number:

Children (living with you, or college age & under)  Birthdate (used to calculate approximate age - actual date will not be printed)

Your email:   Ok to print in directory? Yes No

Information below this line is for club use only - will not print in directory

Residence Status: Member Information Delivery:
Owner- Full Time Resident Put in my TLV Mailbox
Owner -  Part Time Resident Mail to TLV - PO will forward
Owner Non-Resident Mail to non-local address:
Renter - Main House Non-local Address:
Renter - Accessory Apt Non-local City, State Zip:

Any Comments: