WILLARD NEIGHBORHOOD ASSOCIATION
MEMBERSHIP APPLICATION
I would like to support the
Willard Neighborhood Association!
Membership Application 2012
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Membership: Individual |
$ 5. 0 0 | |
|
Family/Household |
$ 1 0. 0 0 | |
|
Business |
$ 2 5. 0 0 | |
|
Contribution: $25, $50, $100 |
$ ___________ | |
|
Other Amount |
$ ___________ | |
|
Total Amount Enclosed |
$ ___________ |
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Name:___________________________________________________ Address:_________________________________________________ City:_____________________________________________________ State:______________________________ ZipCode:____________ Home Phone:____________________________________________ Other Phone (optional):__________________________________ E-Mail:__________________________________________________ Number of People in Family/Business:___________________ Years at Present Address:________________________________ Please Send Check To Willard Neighborhood Association PO Box 2251 South Portland, Maine 04116
Your interest and your active paid membership will help sustain the Willard Neighborhood Association.
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