Please print this page, complete the form, and mail it to the address below. We greatly appreciate your support. Your donations help fund community events, outreach, and activities.

Renew your membership dues with PayPal:

Licton Springs Community Council Membership & Renewal Form

YES! Start my membership. I have enclosed $15.

Please renew my/our membership(s). I have enclosed $15.

Please keep me on your mailing list; no membership at this time.

Address	_______________________________________________________________
City, State; Zip	_______________________________________________________________
Phone	_______________________________________________________________
E-mail Address	_______________________________________________________________

Dues paid cover your membership for the calendar year. We hope that you renew your dues at the beginning of each year. Please support the Community Council's work with your membership!

Make checks payable to :
Licton Springs Community Council

Mail to:
Licton Springs Community Council
c/o Ellen Beck>
9058 Burke Ave. N.
Seattle, WA 98103