BCC Membership form only

Broadview Community Council  Membership Form



Address ________________________________________

City/St/Zip ______________________________________

Phone (work/home)____________________ E-mail ______________________________________

Newsletter Preference:    Paper ______  E-mail _________

Membership: _____$5 Senior   _____$10 Household  ______$75 Business

Note:  Membership is for the current calendar year and cannot be prorated.                          

Renewal ______  New Member ______

Additional Donation _____$25 Benefactor    _____$50 Patron

Print and mail this form with your check to:

                                                                                  Broadview Community Council

                                                                                   P. O. Box 77761

                                                                                   Seattle, WA 98177


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