Print out this page and provide the information requested. Make check payable to TGHNA and return this form to your block captain OR bring to next TGHNA meeting OR mail to:
TGHNA PO Box 160069 St. Louis, MO 63116
MEMBERSHIP FORM
Please Check One:
Individual	$10/year
Household	$15/year
Lifetime (Individual)	$100
Business	$25/year (Entitled to 10% discount on Gazette ad for 1 year)
Name(s): ___________________________________________________________ Check if renewing membership
Street Address: ____________________________________________________________
Phone: _____________________	E-mail: ________________________________________
Please Check ONE:
YES    NO    Include me in the next Buzz Book
YES    NO    Please add my e-mail address to the Neighborhood Forum e-mail list E-mail addresses will only be used for TGHNA purposes and will not be published in the Buzz Book. TGHNA is a tax exempt 501(c)(3)organization. Contributions may be tax deductible