If you would like to join the Town ‘N County
Civic
Association, come to the meeting
Attend a
meeting or send in this application with your check for
$15.00
We appreciate your support!
Date, Fecha:____________________________________________
Last Name,
Apellido____________________________________________
First Name,
Nombre____________________________________________
Middle
Initial, Inicial ______
Address,
Direccion__________________________________________
Apt#
_______________________
Zip, :
_______________________
Spouse,
Conyuge:_____________________________________________
Phone, Numero
de telephono:_____________________________________________
E-Mail Addr.,
Direccion del
Email:_____________________________________________
Occupation,
Oficio:_____________________________________________
Annual Dues: $15.00(Membership
runs for 1 year from date of joining)
Membrecia Annual $15.00(Membrecia
es por un ano empezando con el dia que se inscribe)
New: __________
Renewal:
________
Amt. Pd $
_________Cash ______Check ______ Check # ________
Make check payable to:
Haga
su cheque a nombre de:
TOWN ‘N COUNTRY PARK CIVIC
ASSOCIATION mail to:
P.O.
BOX 262516
TAMPA,
FL 33685
