Membership Form

Name or Contact:                                           Business Name (if applicable):

                   

         Address:  

        

        

         Phone:                                                      Email Address (to receive QuickNews):

                              

         Please choose membership type:

           Family ~ $15.00         Senior Citizen ~ $10.00           Business ~ $25.00

          I can help with:

  Membership           Newsletter          Adopt-A-Road      Fundraising
    Land Use       Fund Raising          Family Fun Day         Ice Cream Social
  Sunset Jazz Fest                Other

Please print this form (from menu bar) and mail along with your
 check or money order to:

Keystone Civic Association ~ Memberships
P.O. Box 95
Odessa, FL  33556