Your name:___________________________________
Address:_____________________________________
Phone: (home)_________________________________
Phone: (work)_________________________________
Phone: (cell)__________________________________
E-mail Address:_________________________________
Idea for Guest Speaker?______________________
If you provide your e-mail address, we can e-mail you periodic news that we hear about between newsletters. We will not share or sell your e-mail address, period!
Mail this slip plus a check for $5.00 for your annual household membership dues to Delaware Avenue Community Association or DACA, c/o Bernadette Wimberley,