Membership Application or Renewal -- 2007-2008

To: Barcroft School and Civic League
c/o Peg Lefebvre, Membership Secretary
812 S. George Mason Dr.
Arlington, VA 22204-1555

___New Member Application or ___Membership Renewal

Individual Membership ($ 3.00). . . . . $______
Couple Membership ($6.00) . . . . . . . $______

Additional Tax Deductible Contribution to the Community House Fund? . . $______

Total:

Name: ______________________________________________
Address: ______________________________________________
Apt: _______
Arlington, VA 22204-_____(zip last 4 if you know it)
Home Phone with area code: 703-___________

E-Mail Address ____________________________
Do you wish your e-mail address shown on the BSCL Web Page? ___Yes ___No
Removed from the Web page? ___Yes ___No

I/we would like to volunteer to help with (please indicate which member):
___Snow Removal for Elderly/Disabled
___Yard Work for Elderly/Disabled
___4th of July Parade & Picnic
___Distribution (Newsletters, Flyers, etc)
___Barcroft Players theater group
___Food Events (Cook-outs, etc)
___Grant Writing
___One-Time Efforts (as they arise)
___Serve on a Committee -- Please specify which one:________________________________
(Crime Resistance, Community House Renovations, Signs, Traffic, etc)

___Other (please specify):_______________________________________________

This page was revised on: September 10, 2007.