Apply

First Name (required)

Last Name (required)

Email (required)

House Number (required)

Street (required)

City (required)

State (required)

Zip Code (required)

Phone Number (required)

Secondary Phone Number

Organization

Do you own or rent?
OwnRent

How long?

Property type:
Single familyDuplexApartment BuildingBusiness

Number of children in family?
0123456+

Preferred method of contact:
Postal ServiceEmailCell

What issues/activities would be of interest to you?
HousingSafetyCommunicationFundraisingStrengthening NeighborhoodsVolunteering (elections, SPCA events...)

Membership level:
Income under $20,000 per year – $20Income between $20,000 and $50,000 per year – $40Income over $50,000 per year – $50Lifetime membership – $500Non-Profit – $75Church – $100Sole proprietorship – $100Small business – $250Corporation – $1,000

(Note: All membership levels except for Lifetime will be automatically billed on an annual basis. You may cancel your membership renewal anytime.)

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