HSM Neighborhood Association
Membership Form
Check
all that apply:
( ) I’d
like to be a member, but I don’t have time to volunteer.
( ) I’d
like to be a member and help out occasionally.
( ) I’d
like to be a member and be an officer if/when a position is available.
( ) I’d
like to be a member and on a committee.
( ) Yes,
I’d like my name, address & phone number published
in the
HSM Neighborhood Association directory.
( ) Enclosed
is my $20 annual dues in check or money order (no cash please)
(Membership
runs January-December each year.)
Names
_____________________________________
Address
____________________________________
Phone
_____________________________________
Email
______________________________________
MAKE
CHECKS PAYABLE TO: HSM N.A.
SEND
TO: TINA LAROCQUE
3987
SARASOTA SPRINGS DR.
FORT
WORTH, TX 76123
Phone:
(817) 263-8554
Email:
TexUkgal@aol.com
Please note: Dues are not deductible as Charitable
Contributions for federal income tax purposes. Please do not pay with cash.