Loyal Order of the Caribbean Soul
(A.K.A Southern Wisconsin Parrothead Club)
Mail to:
LOCS
P.O. Box 75
Cottage Grove, WI 53527
Date:_____________
_____Single Membership ($15/year)
_____Joint Membership ($25/year)
(2 person max. @ SAME address )
Name:_______________________________________
Address:_____________________________________
City:____________________State_____Zip_________
Home Phone:_________________________________
Work Phone:_________________________________
Birthday:_____________________________________
Email:_______________________________________
Favorite Buffett Song:__________________________
Referred By:__________________________________
Name:_______________________________________
Address:_____________________________________
City:____________________State_____Zip_________
Home Phone:_________________________________
Work Phone:_________________________________
Birthday:_____________________________________
Email:_______________________________________
Favorite Buffett Song:__________________________
Referred By:__________________________________
I am willing to help the L.O.C.S/ S.W.P.H.C by:
_____Drinking Boat Drinks & Margaritas
_____Drinking Landshark Lager Beer
_____Write articles for the newsletter
_____Set up for special events
_____Being on a committee (or two)
_____Adopt-A-Highway Clean ups
_____Fundraise for special causes
_____Get Jimmy Buffett to perform in Madison
MEMBERSHIP RENEWAL: June through May (Office Use Only)
______2008-2009 _____2009-2010 _____2010-2011 _____2011-2012