Westchester Playa del Rey Community Council
To use this Registration Application, you will need to download or copy to an email message, complete the form and send to Corliss or Curtiss.
Membership is open to all Westchester Playa del Rey Stakeholders. Just Complete this application Form,, bring it to the next meeting, or reply or forward to Membership Chair,
Eileen Corliss ccorliss@earthlink.net or Curt Curtiss curt7880@aol.com
A Community Stakeholder is defined as any individual who lives (resides), works, or owns property in a (within the) Neighborhood Council area.
Our Council area or boundries are South of Marina del Rey, North of Hawthorne and El Segundo. West of Culver City and Inglewood, to the Pacific Ocean.
Register 30 days prior to voting.
Required information
Name________________________________________________________________________________________
Spouse Name__________________________________________________________________________________
Residence Address__________________________________zip________________Own____________Rent___________
Indicate neighborhood (Kentwood, Osage, Play del Rey etc) ________________________________________________
Phone_____________________________________Fax number________________________________________
Email address_____________________________________________________________________________________
Prior to acceptance as a member, the above information will be verified.
Optional information.
All information on this form is confidential. It will be used by the Staff of the Council only.
In order to represent the many diverse interests in our community as prescribed by DONE we ask you to indicate any
information you care to share regarding your interests.
_______________________________________________________________________________________________
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I would like to be on the Board of Directors_______I would like to participate in the work of the Council______________
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Signature______________________________________________________Date____________________________
Type in your name and add your signature at the next meeting.
The Committee to establish the Community Council is a project of the Westchester Vitalization Corporation
Curt Curtiss Chair. . 310-645-8989