Annual RNA Membership Campaign
June 2017 – May 2018
Join or Renew Today!
Deadline to receive and be listed in the RNA Directory is July 31.
Renewing Member
MEMBERSHIP INFORMATION
New Member
STREET ADDRESS (required) _________________________________________ PHONE ___________________ ZIP 537____
ADULT #1
First Name _____________________________________ Last Name _______________________________________________
Occupation _____________________________________ Email Address ____________________________________________
I do not want my name and info listed in the RNA Directory
Add me to the RNA Listserv
I'm interested in volunteering
RNA committees or Board
Help plan activities
Become Block Captain or Area Rep.
ADULT #2
First Name _____________________________________ Last Name (if different) ______________________________________
Occupation _____________________________________ Email Address _____________________________________________
I do not want my name and info listed in the RNA Directory
Add me to the RNA Listserv
I'm interested in volunteering
RNA committees or Board
Help plan activities
Become Block Captain or Area Rep.
OPPORTUNITIES FOR YOUNG PEOPLE
Please list children and jobs they are interested in.
NOTE: Children's job interests will not be carried over from last year, so please provide updated information.
B - Babysitting O - Odd Jobs P - Pet Walking S - Snow Shoveling Y - Yard Work
Child's Name:
Age:
Jobs (Circle)
_________________
_________
Child's Name:
Age:
_________________
_________
B O P S Y
Jobs (Circle)
B O P S Y
Child's Name:
Age:
Jobs (Circle)
_________________
_________
B O P S Y
Child's Name:
Age:
Jobs (Circle)
_________________
_________
B O P S Y
DUES & DONATIONS
Dues - Check one:
$5.00 - Individual
$10.00 - Family
$25.00 - Institution
$ ________ Additional donation dedicated to RNA Scholarship Fund
for a West High Graduating Senior
Mail completed form and dues payable to RNA to:
RNA Membership
P.O. Box 5655
Madison, WI 53705
Questions? New to the neighborhood? Contact Jon Miskowski at [email protected]
Learn more about our neighborhood at regentneighborhood.org
Thank you! Your involvement keeps our neighborhood thriving!