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Membership Application - May 1, 2016 to April 30, 2017

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Membership Application - May 1, 2016 to April 30, 2017

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Membership Application - May 1, 2016 to April 30, 2017

  1. 1. MEMBERSHIP APPLICATION BROADWAY-FLUSHING HOMEOWNERS’ ASSOCIATION, INC. P.O. BOX 580031, FLUSHING, N.Y. 11358-0031 SERVING THE COMMUNITY SINCE 1964 www.broadwayflushing.org MEMBERSHIP DUES $25.00 PER YEAR (MAY 1, 2016 – APRIL 30, 2017) Name ________________________________________________ Date __________________ Address ______________________ E-mail ____________________________ Telephone _____________ 2nd Voting Member (over 21) _______________________________ PLEASE INDICATE: Member Renewal ________ New Member _________ Yes, I want to volunteer! We really need you! Please list interests: (i.e.: architect, legal, stuff envelopes, garden judging, hospitality, etc.)___________________________________________________________ ________________________________________________________________________________________ Please check if appropriate: ____ **IDO NOT HAVE AN E-MAIL ADDRESS AND PREFER PAPER MAILINGS OF ALL MEETING NOTICESAND NEWSLETTERS** ***ADDITIONAL CONTRIBUTION TO STRENGTHEN THE LEGAL AND RESERVE FUND*** $___________Broadway-Flushing Homeowner: suggested: $50 $___________Broadway-Flushing Patron: suggested: $100 $___________Broadway-Flushing Benefactor: suggested: $200 $___________Broadway-Flushing Preservationist: suggested: $500 $___________Other PROXY I hereby appoint the highest officer of the Executive Committee present at the Membership Meetings of the Association to appear for me to create a quorum and to vote for me as my proxy on all matters coming before the Membership Meetings of the Association to be held in October, February and May. If I attend any of the meetings, this proxy is void as to those I attend. __________________________________________ _____________________________________ Signature, Printed Name and Address Second Voting Member Signature, Printed Name and Address

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