Membership Form
Maple Leaf Community Council, PO Box 75595, Seattle, WA 98125

Name______________________________________________ Home Phone_______________________

Address__________________________________ZIP_______ Work Phone_______________________

Membership: Individual/Family-$15__ Senior-$2 minimum__ Benefactor-$30__ Patron-$60__ Business-$50__

Circle Issues you would like to be involved in:

Transportation and Land Use
Garden Club
Neighborhood Planning
Board Member
 Space Jam
Scholarship Foundation
Parks
Newsletter
Graffiti Control
 Noise Control
Aircraft Noise
Dues/Membership
Block Watch
Other___________