[Company Logo Image] Lebanese - American Club Of Michigan
P.O.Box 1452
Warren, MI 48090
Phone (586) 447 2263
E-mail  chuckgem@yahoo.com
 

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Standard Application: 

Please print and fill out the membership form below and mail it to the address above or scan and email to chuckgem@yahoo.com

Membership Form (PDF File)

 

Electronic Application

Please fill the form below and click the Submit Button to send it electronically to us:

 

Full Name:

   Phone Number:  
 
Street:  
City:   State:   Zip:     
Email:  
  
Date of Birth:   / / Place of Birth:  
 
Occupation:   Company:  
  
Spouse Name:  

Occupation:

 

Children's Names:  
   
Hobbies:  
  
Sponsored By:

 
Applicants must be sponsored by one or more current LACOM members;
Others will not be considered.