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             Grand Mound Rochester Park Association
                                PO Box 1266  Rochester WA  98579
(360) 273-0398


                                MEMBERSHIP APPLICATION
June 1, 2015 May 31, 201

 Name __________________________________________________________________

 Mailing Address _________________________________________________________

 Phone ___________________________  Email ________________________________

          Check if you do not want your name(s) included on membership lists or appearing in printed materials. 
Your personal information will NOT be shared.

Signature(s) _______________________________________ Date _________________


                                I/We Would Like To Volunteer!
(check all that apply)

_____Computers                                 _____ Office Work                  _____Landscaping      

_____ Event Set up/Clean up               _____Painting                          _____Carpentry

_____Fundraising                                 _____ Photography                  _____Board Member

_____Other (please describe)________________________________________________


                            Thank You!

If you desire additional information about the Grand Mound Rochester Park Association or the Rochester Community Park, e-mail

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