Crooked Creek Heights South

MEMBERSHIP FORM

Mar 07, 2000

MEMBERSHIP FORM

Names (you and your spouse)_________________________________ ____________________________________________________________

Home Phone__________________________________________________

E-mail______________________________________________________

Address_________________________________________________________________________________________________________________

(circle your response)

I consent to publication of the information contained on this membership form (for official neighborhood use only):
YES No

If you would like to volunteer or are interested in any of the following, please check the item(s):
?• Being a Board Member q Being an Association Officer
?• Being a CrimeWatch Block Captain q Helping maintain entrance areas
?• Other_____________________________


Please complete and return this form with a $30 check payable to: Crooked Creek Heights South Neighborhood Association (CCHSNA). Mail to Kenny Abell (Treasurer); 7426 Crickwood Place; Indianapolis, IN 46268.