Name ___________________________________
Neighborhood _________________
Address ___________________________________________________
Zip ________
Phone # - day ________________ evening ______________
E-mail _________________________________________________________________
Membership Category
Please circle your membership level
Patron
($250+)
|
Household ($25-$49)
|
|
Business ($50-$100)
|
Seniors & Students ($5-$24)
|
|
Members receive SEACommunications
ten times a year, may borrow tools and equipment from the tool library,
are eligible to join the Genesee Co-Op Credit Union, and are appreciated
as really GREAT neighbors!
|
I am a (Please circle one!)
Business Homeowner Landlord
Tenant
My special concerns are __________________________________________________
_______________________________________________________________________
_______________________________________________________________________
I would like to volunteer to ________________________________________________
_______________________________________________________________________
_______________________________________________________________________
