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Information Change Form
To change, correct, or update your membership information, fill in contact and business name below. Then, ONLY fill in the fields that need adding, correcting, or changing.

Contact Name:

Business Name:

E-mail:

Please fill in ONLY the fields below that you wish to have changed, added, updated or corrected.

Check this box if you have a new e-mail address. The e-mail address above should be your new e-mail address.
Business Phone: Fax:
Mailing Address:
City: State:
Zip:
lakeanna.org
Use the above mailing address on the web site.
Use the address below on the web site.
Directory Listing Address:
City: State:
Zip:
Use the above business phone number on the web site.
Use the phone number below on the web site.
Directory Phone:
Web Site URL (www.yourwebsite.com):
Use the above E-mail Address on the web site.
Use the E-mail Address below on the web site.
E-mail:
Select a category below that you want your business changed to on the directory of the web site. (If you don't find a category that fits your business just fill in the other box and we will change it on the web site.)
Type of Business: Click on all that apply.
Hold down the CTRL key to select more than one.

Other:
COMMENTS OR ADDITIONAL INFORMATION:

Please list the name and email address of the social members you would wish to ADD, if you are an existing Class A-F membership. Thank You.

1. Name: 1. Email:
2. Name: 2. Email:
3. Name: 3. Email:
4. Name: 4. Email:
5. Name: 5. Email:
6. Name: 6. Email:
7. Name: 7. Email:
8. Name: 8. Email:
9. Name: 9. Email:
10. Name: 10. Email:
11. Name: 11. Email:
12. Name: 12. Email:

Please list the name and email address of the social members you would wish to REMOVE, if you are an existing Class A-F membership. Thank You.

1. Name: 1. Email:
2. Name: 2. Email:
3. Name: 3. Email:
4. Name: 4. Email:
5. Name: 5. Email:
6. Name: 6. Email:
7. Name: 7. Email:
8. Name: 8. Email:
9. Name: 9. Email:
10. Name: 10. Email:
11. Name: 11. Email:
12. Name: 12. Email:

 

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Lake Anna Business Partnership
5753 Courthouse Rd. Suite #5
Spotsylvania, VA 22553
(540) 895-0100

Questions? Please feel free to contact us:
E-Mail: information@lakeanna.org

  

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