Friends of the Jim Lucas Checotah Public Library
Please print and complete this application
Return it with your dues payment to the circulation desk at the Jim Lucas Checotah Public Library
OR mail to
Jim Lucas Checotah Public Library
626 West Gentry
Checotah, OK 74426
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Last Name |
First Name |
Middle Initial |
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Street Address |
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City |
State |
Zip |
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Home Telephone |
Alternate Phone |
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Alternate E-mail Address |
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(Please print clearly in blue or black ink. Thank you.)
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Type of Membership |
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Individual Yearly |
$5.00 |
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Family/Individual Lifetime |
$50.00 |
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Donation |
$______ |
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TOTAL |
$______ |