SaddleBrooke Community Outreach (Tax ID 86-0843458) Individual Registration - 2008/2009

This form is for Paypal payments only. If you do not want to pay on line, you can fill out the form at www.community-outreach.org/join.htm and submit it with your check payable to SaddleBrooke Community Outreach to Ken Siarkiewicz at 37104 S. Ridgeview Blvd (Unit 16, lot 52) 818-0425 or our office at 63675 SaddleBrooke Blvd, Suite L, SaddleBrooke Plaza - office hours M/T/W 9 a.m. to 8 p.m. Tax I.D. 86-0843458.

1. First and last name
2. New member or returning member? (click down arrow to choose)
3. Active member or supportive member? (click down arrow to choose)
4. I want to volunteer for the following (optional - click down arrow to choose)
5. Street address in SaddleBrooke
6. Local telephone number (or cell phone number)
7. Unit number
8. Lot number (Optional)
9. Email address (optional)