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Member Signup Form

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Required info:
* Email address:
* Name:
* Password:
* Repeat:
Personal Information:
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Neighborhood Association Information:
Neighborhood Association Name:
UNSCC Member? Yes No
UNSCC Member Type?
City:
Neighborhood Boundaries:
North:
South:
East:
West:
Additional Neighborhood Association Information:
Website URL:
Year Established:
Number of Households:
Number of Members:
Organization Mission:
Recent Projects:
Neighborhood Contacts - UNSCC Representative, Neighborhood Association President, Treasure, and Planning & Land Use Chair (PLUC):
Include Contact Info in UNSCC Directory: Yes No
UNSCC Rep Name:
UNSCC Rep Phone:
UNSCC Rep Address:
UNSCC Rep City, State, Zip:
UNSCC Rep Email:
President Name:
President Phone:
President Address:
President City, State, Zip:
President Email:
Treasurer Name:
Treasurer Phone:
Treasurer Address:
Treasurer City, State, Zip:
Treasurer Email:
Planning & Landuse Chair (PLUC) Name:
PLUC Phone:
PLUC Address:
PLUC City, State, Zip:
PLUC Email:
Government Representatives:
City Council District:
County Supervisor District:
State Assembly District:
State Senate District:
US Congressional District:
 



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