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

                                                 
                                                      www.rochester-wa.com

                                MEMBERSHIP APPLICATION
                                      
June 1, 2015 May 31, 201
6

 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
waliddle@msn.com

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