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VENETIAN VILLAGE CIVIC ASSOCIATION 2012 DUES APPLICATION FORM
NAME_________________________________ DATE:_______________________
ADDRESS______________________________ $20.00 yearly household dues: ____________
(yrly dues incld 1-sticker)
EMAIL:_________________________________ $5.00 Building Fund ____________
if you include your email address we will send our
newsletters and meeting info to you.
$1.00 each additional sticker ____________
PHONE# ______________________________ Misc. Additional $ donations ____________
TOTAL ENCLOSED: ____________
Total # of Auto Stickers Needed: ____________
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