Join PSCA

MEMBERSHIP APPLICATION

NAME: _____________________________________________________________________

ADDRESS: __________________________________________________________________

PHONE: ____________________________________________________________________

E-MAIL: ____________________________________________________________________

OCCUPATION: _____________________________________________________________

· Neighborhood directory for possible services in the neighborhood

· IE: Attorney, Insurance, Construction, lawn services, etc.

NEIGHBORHOOD CONCERNS:

A_________________________________________________________________________

B_________________________________________________________________________

C________________________________________________________________________

D_________________________________________________________________________

*We do not give or sell our members e-mail addresses

DUES: $20.00 A YEAR PER PERSON (PAID IN FULL)

WITH YOUR SUPPORT, WE CAN CONTINUE OUR WORK ON BEHALF OF THE ENTIRE NEIGHBORHOOD. DUES ASSIST US BY THE FOLLOWING:

LITERATURE, MATERIALS, SPECIAL PROJECTS AND ACTIVITIES.

Please bring to meeting or mail to:

Ken Crawford

2018 Fletcher Street

Hollywood, Florida. 33020

954.929.3696