NEIGHBORHOOD
MEMBERSHIP APPLICATION
PLEASE PRINT OUT THIS
FORM FROM YOUR COMPUTER, FILL-IN ALL INFORMATION
BELOW AND SEND FORM TO:
GHPA, 712 MAIN STREET, STE. 110, HOUSTON, TX 77002
The
cost for membership in Historic Neighborhoods Council
is $50 per year. Greater Houston Preservation Alliance is a 501(c)(3) corporation. Contributions are
tax deductible to the full extent allowed by law.
Thank you for joining HNC.
ORGANIZATION___________________________________________________________
CONTACT
OR REPRESENTATIVE____________________________________________________
ADDRESS ____________________________________________________________
CITY, STATE, ZIP________________________________________
HOME PHONE / BUSINESS PHONE_________________________________________________
FAX ______________________ E-MAIL
_____________________________
NEIGHBORHOOD WEBSITE ADDRESS______________________________
OUR NEIGHBORHOOD ASSOCIATION MEETS_________________________________________________________________________
TODAY'S
DATE ______________________
Payment
is accepted via check, money order or credit card (VISA/MC,
Amex or Discover). Please make checks payable to Greater Houston Preservation Alliance.
PAYMENT
INFORMATION :
o
Payment enclosed
Charge
my: o VISA o MasterCard o AMEX
Card
No._____________________________ Exp. Date_________
Signature
of Card Holder __________________________________
Please
list names, addresses and e-mail addresses of up to
four neighborhood representatives who should receive
the newsletter and notices, in addition to the person
listed above:
NAME____________________________________________________
ADDRESS _______________________________________________________
CITY, STATE, ZIP________________________________________
HOME PHONE / BUSINESS PHONE_________________________________________________
FAX ______________________ E-MAIL
_____________________________
NAME____________________________________________________
ADDRESS__________________________________________________________
CITY, STATE, ZIP________________________________________
HOME PHONE / BUSINESS PHONE_________________________________________________
FAX ______________________ E-MAIL
_____________________________
NAME____________________________________________________
ADDRESS_________________________________________________________
CITY, STATE, ZIP________________________________________
HOME PHONE / BUSINESS PHONE_________________________________________________
FAX ______________________ E-MAIL
_____________________________
NAME____________________________________________________
ADDRESS ________________________________________________
CITY, STATE, ZIP________________________________________
HOME
PHONE / BUSINESS PHONE_________________________________________________
FAX ______________________ E-MAIL
_____________________________
