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E-mail addresses will only be used for TGHNA purposes and will not be published in the Buzz Book.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