We are not equipped to accept membership payments over
the Internet at this time. Please print out this form, fill it
out, and mail it in to our Treasurer at the address listed.

LEEWAY OVERLEE CIVIC ASSOCIATION
MEMBERSHIP APPLICATION
Please complete this form and mail it with a check
for $5.00 per adult to:


Jennifer Michener
5605 23rd St. N
Arlington, VA 22205

Make check payable to:
LEEWAY OVERLEE CIVIC ASSOCIATION
           Check if you wish a receipt. Enclose a self-
addressed, stamped envelope.
           Check if you are willing to help with the
distribution of THE LEEWAY OVERLEE
LEADER.
 
Name(s)                                
 
Address                                
 
 
Zip                Phone                  
 
E-mail address                            
 
Amount Enclosed $                         
 
Membership Year:                          
 
Thanks for your support