Bellevue Civic Association

Membership Application

(Payment via PayPal)

Family Name

Family Size

1 2 3 4 5 6 7 8+

I would like to serve on the following Committee(s)

Select a committee None Membership Education Finance/Fundraising Security Patrol Newsletter Reporter Newsletter Ads Newsletter Editor Newsletter Other Neighborhood Watch Neighborhood Cleanup Garden Walk Plant Swap Marathon Programs Other

Select a committee None Membership Education Finance/Fundraising Security Patrol Newsletter Reporter Newsletter Ads Newsletter Editor Newsletter Other Neighborhood Watch Neighborhood Cleanup Garden Walk Plant Swap Marathon Programs Other

Select a committee None Membership Education Finance/Fundraising Security Patrol Newsletter Reporter Newsletter Ads Newsletter Editor Newsletter Other Neighborhood Watch Neighborhood Cleanup Garden Walk Plant Swap Marathon Programs Other

Email Address

Telephone Number

Dues are $15 per calendar year. Be sure to complete the shipping information on the PayPal site. This will be your address of record.