Polka Lovers Membership

Membership is open to full and temporary residents who live in The Villages, FL

Complete form and send using “Send Form” below or print and bring to next Polka Lovers event.

Dues $10.00 per person per season.

If a current member, please pay the dues before Mid-November.

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Name *

First

Last

Additional Member Name

First

Last

Email

Email address is used for newsletter. If you don't want the newsletter, please leave blank.

Contact Phone *

Comment or Message

Your Village Address *

Village You live in: *

Home State

Payment: *

• Pay at next event
• MAIL Payment of check written to Polka Lovers Club to Pat Mason, 3513 Sterling Street, The Villages, FL 32162 Phone: 908-403-6527

Please note: Membership will not begin until payment is received. At that time, you will be eligible for newsletters and membership pricing for dances.

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