Membership Form

Please print this page, fill in the blanks, and mail it to us at the address below or bring it to the next meeting.

Name:    _________________________________________________________________

Address: _________________________________________________________________

City/State/Zip: __________________________________________________________

Phone: ___________________________________________________________________

Email: ___________________________________________________________________

Membership for one year:

Under 60: $10.00 per person ________

Over 60: $5.00 per person   ________

Donation for newsletter postage:  ___________

This is a ___ New / ____ Renewal membership

Note:  SLN membership dues are due September 1 and are good through June 30.  Verification of address is required before the first view.  Verification may include a picture ID with address, driver’s license, phone bill, etc.

Mail to:

South Lakeview Neighbors
1505 W. Oakdale Avenue
Chicago, IL 60657

Please make checks payable to:  South Lakeview Neighbors