MEMBERSHIP FORM

MANDELL PLACE CIVIC ASSOCIATION

Your membership (due Jan. 1 each year) helps us improve our neighborhood, take on special projects, keep you informed and manage other vital tasks.

Join today!

Please fill out this form and mail it with your check made out to:

Mandell Place Civic Association (MPCA)

P O Box 66005

Houston, TX 77266-6005

Name: ________________________________

Address: ________________________________

________________________________

Phone: _________________________________

e-mail address:________________________________

 Annual Dues (Please check one)

______ $150 Patron ___ $50 Contributing

______ $100 Sustaining ___ $25 Member

Other ($_________)

Thank you!