LCPOA Membership Form 2019 V1

Having problems? Click Here

2019v1 01/24/2019 11:02am

Property Address

Street Address Number*

Street Name*

Select a street name.

Unit #

Is your postal address different from your property address*

Yes No

Mailing Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Contact Information

Are you a Homeowner in: Lake Country Estates or Lake Country Secret Harbour?*

Yes No

Yes (You are applying for Full Membership), No (You are applying for Associate Membership)

List of Associated Neighborhoods | LCPOA Boundary Map

Home Ownership*

I Own My Home I Am Not The Homeowner (Rent or Lease)

Over 65 Years of Age*

No Yes

If you are OVER 65 years of age choose "Yes"

Membership Dues Price $

Your Full Legal Name*

First Name

Last Name

Email Address*

Confirm Email Address *

Enter your email address

Phone Number*

ex. (817) 555-1212

Alternate Phone Number

Full Legal Spouse Name

First Name

Last Name

Spouse Email Address

Confirm Spouse Email Address *

Dues & Fees

Membership Dues*

Membership Dues Already Joined this Year

Dues Amount $

Do you want an Amenities Key?*

No Yes

(For security purposes, locks are changed yearly; 1st key included in your membership at no charge; Provides access to Waterfront Park Pavilion Area and Tennis/Basketball Courts)

Additional or Replacement Amenities Key*

No Yes

Key Price $

Key Fee Amount $

Enter # of Boat Launch Permits*

You may apply for up to 4 launch permits.

Boat Launch Permit Amount $

Donation*

Donation Amount $

Donation Quantity

Your Purchase Total Is

$

Boat Ramp - Launch Permits

All Launch Permits are valid only for the year in which they are purchased and do not carry over to the next year. All launch permits expire at Midnight of Dec 31st of each year.

All member vessels required by the Texas Parks and Wildlife Department (TPWD) to be licensed shall provide vessel license information and the owner’s registration information must concur with the member’s name and address. And when such vessel is placed upon a trailer for towing such trailer license shall be provided by the member. Those members not providing the required information will not have their launch permit requests fulfilled. (To view the Launch Permit Eligibility Policy visit www.lcpoa.org)

1st Launch Permit

When entering license information, PLEASE USE UPPERCASE LETTERS ONLY.

DO NOT ENTER any SPACES or DASHES.

Have you ever purchased a launch permit for this vessel before? (p1)*

Yes No

If you have every purchased a launch permit for this vessel (regardless of which year it was issued to you in) and the decal still exists on the trailer used to tow the vessel then enter the decal number in the decal number field?

LCPOA Barcode Decal Number (p1)*

Enter the existing launch permit decal number located on your trailer regardless of which year it was issued to you.

Trailer License Plate Number (p1)*

Enter the current trailer license plate number located on your trailer which the vessel is loaded on for towing.

Number of vessels on Trailer (p1)*

1 Vessel 2 Vessels

Enter the number of vessels on your trailer

1st Vessel - TPWD TX Number (p1)*

Enter the Texas Parks & Wildlife TX Number located on the bow of the vessel.

2nd Vessel - TPWD TX Number (p1)*

Enter the Texas Parks & Wildlife TX Number located on the bow of the vessel. (i.e. TX1234AA)

Does your name appear on the title? (p1)*

Yes No

If you are not the legal owner of the vessel an additional fee may be charged.

Launch Permit Fee Amount (p1) $

Permit Note (p1)

Enter any additional information you wish to communicate.

Documentation Upload (p1)

No File Chosen

File uploads may not work on some mobile devices.

Upload any supporting documentation (pictures & PDF only).

2nd Launch Permit

When entering license information, PLEASE USE UPPERCASE LETTERS ONLY.

DO NOT ENTER any SPACES or DASHES.

Have you ever purchased a launch permit for this vessel before? (p2)*

Yes No

If you have ever purchased a launch permit for this vessel (regardless of which year it was issued to you in) and the decal still exists on the trailer used to tow the vessel then enter the decal number in the decal number field

LCPOA Barcode Decal Number (p2)*

Trailer License Plate Number (p2)*

Enter the current trailer license plate number located on your trailer which the vessel is loaded on for towing.

Number of vessels on Trailer (p2)*

1 Vessel 2 Vessels

Enter the number of vessels on your trailer

1st Vessel - TPWD TX Number (p2)*

Enter the Texas Parks & Wildlife TX Number located on the bow of the vessel. (i.e. TX1234AA)

2nd Vessel - TPWD TX Number (p2)*

Enter the Texas Parks & Wildlife TX Number located on the bow of the vessel. (i.e. TX1234AA)

Does your name appear on the title? (p2)

Yes No

If you are not the legal owner of the vessel an additional fee may be charged.

Launch Permit Fee Amount (p2) $

Permit Note (p2)

Enter any additional information you wish to communicate.

Documentation Upload (p2)

No File Chosen

File uploads may not work on some mobile devices.

Upload any supporting documentation (pictures & PDF only).

3rd Launch Permit

When entering license information, PLEASE USE UPPERCASE LETTERS ONLY.

DO NOT ENTER any SPACES or DASHES.

Have you ever purchased a launch permit for this vessel before? (p3)*

Yes No

If you have ever purchased a launch permit for this vessel (regardless of which year it was issued to you in) and the decal still exists on the trailer used to tow the vessel then enter the decal number in the decal number field

LCPOA Barcode Decal Number (p3)*

Trailer License Plate Number (p3)*

Enter the current trailer license plate number located on your trailer which the vessel is loaded on for towing.

Number of vessels on Trailer (p3)*

1 Vessel 2 Vessels

Enter the number of vessels on your trailer

1st Vessel - TPWD TX Number (p3)*

Enter the Texas Parks & Wildlife TX Number located on the bow of the vessel. (i.e. TX1234AA)

2nd Vessel - TPWD TX Number (p3)*

Enter the Texas Parks & Wildlife TX Number located on the bow of the vessel. (i.e. TX1234AA)

Does your name appear on the title? (p3)*

Yes No

If you are not the legal owner of the vessel an additional fee may be charged.

Launch Permit Fee Amount (p3) $

Permit Note (p3)

Enter any additional information you wish to communicate.

Documentation Upload (p3)

No File Chosen

File uploads may not work on some mobile devices.

4th Launch Permit

When entering license information, PLEASE USE UPPERCASE LETTERS ONLY.

DO NOT ENTER any SPACES or DASHES.

Have you ever purchased a launch permit for this vessel before? (p4)*

Yes No

If you have every purchased a launch permit for this vessel (regardless of which year it was issued to you in) and the decal still exists on the trailer used to tow the vessel then enter the decal number in the decal number field?

LCPOA Barcode Decal Number (p4)*

Trailer License Plate Number (p4)*

Enter the current trailer license plate number located on your trailer which the vessel is loaded on for towing.

Number of vessels on Trailer (p4)*

1 Vessel 2 Vessels

Enter the number of vessels on your trailer

1st Vessel - TPWD TX Number (p4)*

Enter the Texas Parks & Wildlife TX Number located on the bow of the vessel. (i.e. TX1234AA)

2nd Vessel - TPWD TX Number (p4)*

Enter the Texas Parks & Wildlife TX Number located on the bow of the vessel. (i.e. TX1234AA)

Does your name appear on the title? (p4)

Yes No

If you are not the legal owner of the vessel an additional fee may be charged.

Launch Permit Fee Amount (p4) $

Permit Note (p4)

Enter any additional information you wish to communicate.

Documentation Upload (p4)

No File Chosen

File uploads may not work on some mobile devices.

Upload any supporting documentation (pictures & PDF only).

Terms and Conditions for Access to Facilities

I have read and understood the Lake Country Property Owner's Association, Inc. Terms and Conditions for Access to Facilities.

Policies & Procedures subject to change without notice.

Click Here To View the LCPOA Terms and Conditions for Access to Facilities

Terms and Conditions*

YES, I have read, understood and Agree to the Terms and Conditions for Access to Facilities.

Pay By

Payment

Your Credit Card will be charged this amount $

Credit Card

Default Number 1

Empty String Field

Payment Type