Lowanne Nimat Lodge

A National Service Award Winning Lodge

2016 Lodge Registration & Dues

Lowanne Nimat Lodge dues are $15.00 annually and cover the period from January 1st to December 31st each year. 2016
marks the exciting start of our second century of service. PLEASE PAY YOUR DUES TODAY! Dues can be paid at most
Lodge functions and also at the Council Office in person or by completing the form below and mailing it with your payment to
the address shown. Cash can be used if paying in person; otherwise a check, money order, or credit card is acceptable.
Once your payment is processed a lodge membership card will be mailed to you.
Members who are delinquent in paying their dues for one or more years can be restored to active status by paying a reactivation processing fee of $5.00 in addition to their current years dues of $15.00 (Total $20.00).
It is required that an individual be registered with the Boy Scouts of America to be a member of the Order of the Arrow. If your
BSA membership lapses so does your membership in the OA. Those first inducted into the Order in 2015 have already paid
their 2016 dues in their Ordeal fee. All other members please use this form to pay your annual dues.
Dues or other lodge related questions may be addressed to brotherronofthenorth@gmail.com.

2016 Dues & Registration Form

RETURN WITH PAYMENT TO: Longhouse Council, BSA
2803 Brewerton Road, Mattydale, NY 13211-1000

Name___________________________________________________ Date_________________
LAST

FIRST

MIDDLE INITIAL

Address______________________________________________________________________
STREET

CITY

STATE

ZIP CODE

Telephone_______________________________ Email _______________________________

HOME

CELL

Unit ___________________ District_________________ Date of Birth ___________________

BSA Personal ID ____________________ (Located at the bottom of BSA membership card)
Position in Scouting ____________________________________________________________
Payment: Check or Money Order
$___________ Amount
Made Payable to:
Longhouse Council

Credit
Card

__ American Express
__ MasterCard

__ VISA
__ Discover

Card No.__________________________
Expiration Date ___________________
CVV/CV2/CVN/CID _________________