How this works. You will complete this form and submit it.
The form will be received by our Membership Coordinator who will enter your
information into our database. They will them prepare a special Welcome
Pack and mail it to you.
You're all set! Congratulations on becoming a participating
member of your Neighborhood!
You will start receiving your monthly newsletter after one full
month as it takes time to process the information through us to the printer.
You membership dues are due every year in February.
Primary First Name
Primary Last Name
Secondary First Name
SecondaryLast Name
Street Address
Address (cont.)
City
State
Zip Code
Home Phone
E-mail
URL (if any)
Help us define who makes up Benton Park. This selection is option but, it
would help us promote our neighborhood:
Years lived in Benton Park
Years member of BPNA
Residency
Own
Rent
# of children
Do you wish the newsletter to be mailed to you
by:
Print
by US Mail
PDF by eMail
Select any of the following Committees that you would be interested in helping
with:
Mardi GrasHouse Tour MembershipParksGarden ClubBuilding ReviewNewsletterWeb SiteProblem PropertiesPublic RelationsChalk Art Other
Business Application:
First Name
Last Name
Title
Business Name:
Street Address
Address (cont.)
City
State
Zip Code
Work Phone
FAX
E-mail
URL
If you would like to place a business card sized advertisement in our newsletter, please fill out the following
information;
Monthly $20/month (members) or
$25/month
(non-members) Yearly
$150/month (members) or
$200/month
(non-members)
