Citizens Information Form

Lower Macungie Township E-Privacy Policy
Dear Citizens of Lower Macungie Township,

You'll be pleased to know that your Township is in the process of developing a 'cutting edge' communication strategy that will significantly improve the flow of valuable township service information between us, save us money and make us even more efficient.  To accomplish this task, we are asking for your support in the gathering of information about yourself and your family's interests in various township services.

We would be very appreciative if you can fill out as much of the form below as possible: telephone number and e-mail address are VERY IMPORTANT!
1. Salutation:
2. First Name: *
3. Last Name: *
4. Address: *
5. Suite/Apt/Etc.:
6. City / State / Zip: , -*
7. Development:
8. Home Phone: *
9. Cell Phone:
10. Email address (Home): *
11. Username: *
12. Password: *
Confirm Password: *
(Password must be 6-15 characters and include at least one letter and one number)
13. Program Area Interests: please check all that apply for you and your family
 Babysitting Class,   Dance Night: Father/Daughter,   Kids Art,   Kids Craft/Sewing,   Kids Golf, 
 Summer Programs/Camps,   Swimming Lessons,   Adult Art,   Adult Crafts/Sewing,   Adult Dance, 
 Boating,   CPR,   Pilates,   Tai Chi,   Yoga, 
 Zumba,   Baking & Cooking Classes,   Mommy/Daddy & Me Programs,   Pool Pass Users,   Tennis
14.  Blood Drive Donor
15.  Lower Macungie Library Patron
16.  Newsletter
17.  Special Events (Ex. Job Fair, Pics w/ Santa, etc)
18.  Troop Support Program
19.  Walkercise
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