Est. 1957


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APPLICATION FOR MEMBERSHIP

(Print & Mail)

P.H.N.A. Membership Form

 

 

$7.00 for yearly Membership

Mail your dues today to:

PHNA Membership Secretary
4
Rowley Street
Dorchester, MA 02122

Print and return with your payment; If you have already paid your dues, please answer the few questions and mail back to us so we can plan our meetings accordingly. Thank you.

Name:_______________________________________________________________

Spouse Name:_________________________________________________________

Address______________________________________________________________

Phone Number:_________________________

Email Address: _______________________________ 

New Member: _______ Renewal: _______

1)     How long have you been a resident of the Pope’s Hill area?

_____ Years ____ months

2) What types of information would you like to see at the monthly meetings?

_____________________________________________________________________

3) Who would you like to hear speak at the monthly meetings?

_____________________________________________________________________ 

 

 

 

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