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Online Membership Form

 


Please enter your information below:

Name:

Street Address:

City, State, ZIP:

Phone Number:

Email Address:


I would like to receive email updates on PPNA news and events.


Please select one for yearly dues:

$15.00 per Household
$25.00 per Business
$8.00 per Senior Household


Please check any and all areas for which you would be willing to volunteer/participate:

Economic Development/Zoning (Residential/Retail Development, Restaurants/Entertainment/Cultural Venues)
Special Events (Parade, Holiday Party)
Childrens Activities
Seniors Activities
Fundraising
Community Service
Newsletter (Distribution, Writing)
Portage Park History
Garden Club
Safety/CAPS
Other:


Please list any special skills or background you have: (Public Relations, Legal, Accounting, Musical/Artistic, Bilingual, etc.)

Please list any ideas you have in regards to PPNA mission and activities:


updated 09/02/2007 | comments