BRETON BAY CIVIC ASSOCIATION MEMBERSHIP APPLICATION
2009 membership DUES/DONATIONS
Please remit your check to BBCA, PO Box 67, Leonardtown, MD 206540
Name: _____________________________________________________
Street Address: _____________________________________________________
_____________________________________________________
Phone: _________________ Own____ Rent_____
E-Mail Address: _____________________________________________________
Would you like to receive your information via e-mail? Yes No
Annual Dues: $50.00 (Includes 2 tags) dues are not prorated
Beach Donation: _____________
Additional Tags: ____________ $10.00 Each (Limit 2)
Total Check: _________________
Are you interested in volunteering with BBCA? If yes, what is best time and phone number where you can be reached? _______________ __________________
Best Time to Call Phone No.
------------------------------------------------------------------------------------------------------------------------------------------------
cut here to keep contact information
Should you have any questions, please feel free to contact any member of the 2009 Executive Board: Joe Bell, President 301-475-3766, bellj@md.metrocast.net; Marianne Romero, Vice President, 301-475-9321, pr5471@aol.com; Jennifer Campbell, Treas 301-475-9674, jawinva@yahoo.com; or Maureen Rotto-Coar, Secy, 301-475-3933, MaureenR@csmd.edu.]
To reserve Pavilion, call Marianne Romero above.