The Greater Shady Grove Civic Alliance
GET INVOLVED IN LOCAL COMMUNITY ISSUES
PRINT, FILL OUT AND MAIL THIS FORM TODAY! Membership is open to individuals, civic organizations and homeowners’ associations.
Please select from the following:
___ I am enclosing $10 cash ( ) check ( ) for my annual household membership
___ I am enclosing $15
cash ( ) check ( ) for the following organization membership:
______________________________________________________________________________________________
(Please make check payable to: “Greater Shady Grove Civic Alliance”) and mail to: Pat Labuda, GSGCA, 16929 Briardale Road, Derwood, MD 20855
Name: _______________________________________________________
Address: _______________________________________________________
Phone: ___________________ E-Mail: ___________________________
Local Issues of Concern
to You:_____________________________________________