WILLARD NEIGHBORHOOD ASSOCIATION

MEMBERSHIP  APPLICATION

 

 

I would like to support the

Willard Neighborhood Association!

 

Membership Application 2014

 

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

$ ___________

 

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

help sustain the

Willard Neighborhood Association.

 

H o m e