Round Up
Enrollment Form

Please sign me up for: Round Up       Round Up Plus: $

Donate to: (check only one):
  • A Kid's Place
  • Crockett Elementary
  • Crossroads Coffee House
  • E. O. Coffman Middle School
  • Ethridge Elementary
  • God's Storehouse
  • Ingram Sowell Elementary
  • Lawrence County Education Foundation
  • Lawrence County High School
  • Lawrence County Humane Society
  • Lawrence County Public Library
  • Lawrenceburg Public
  • Leoma Elementary
  • Loretto High School
  • New Prospect Elementary
  • Red Cross
  • Sacred Heart (Lawrenceburg)
  • Sacred Heart (Loretto)
  • Safe-N-Smart
  • South Lawrence Elementary
  • Spirit of Santa
  • Summertown Elementary
  • Summertown High School
Utility Account Number:   --
City, State Zip:
  ()- -

Signature: _______________________________________________

Please be sure to complete this form entirely, print it, sign it and mail to:

Lawrenceburg Utility Systems
ATTN: Round Up
PO Box 649
Lawrenceburg, TN 38464

LUS Logo Lawrenceburg Utility Systems is proud to partner with our community!