North of Grand Neighborhood Association

NOG MEMBERSHIP FORM

May 20, 2002

NOG MEMBERSHIP FORM

Name ____________________________________

Address___________________________________

City _____________________________________

State __________________Zip___________________

Phone _________________

__Renewal membership __New Membership

Membership Type: General Membership is open to everyone. Voting members must live, work, rent, or own property within NOG boundaries.

__Individual*$12/year __Household*$22/year
__Business*$30/year __Patron*$50/year

Check all that applies:
__Live in NOG __Own a business in NOG
__Own property in NOG __Work within NOG

I am interested in serving on the following committees:
__Beautification __Block Captains
__Membership __History
__Newsletter __Public Affairs
__Welcoming

Make Checks Payable and Mail to:
North of Grand Neighborhood Association
P.O. Box 12027
Des Moines, IA 50312