Renewing Member New Member

First Name _____________________________________ Last Name _______________________________________________

Occupation _____________________________________ Email Address ____________________________________________

I do not want my name and info listed in the RNA Directory

Add me to the RNA Listserv I'm interested in volunteering RNA committees or Board

First Name _____________________________________ Last Name (if different) ______________________________________

Occupation _____________________________________ Email Address _____________________________________________

I do not want my name and info listed in the RNA Directory

Add me to the RNA Listserv

I'm interested in volunteering RNA committees or Board

Please list children and jobs they are interested in.

Child's Name: Age: Child's Name: Age:

_________________ _________ _________________ _________

Child's Name: Age: Child's Name: Age:

_________________ _________ _________________ _________

Dues - Check one: $5.00 - Individual $10.00 - Family $25.00 - Institution

$ ________ Additional donation dedicated to RNA Scholarship Fund for a West High Graduating Senior

Mail completed form and dues payable to RNA to: RNA Membership

P.O. Box 5655Madison, WI 53705

B O P S Y

DUES & DONATIONS

OPPORTUNITIES FOR YOUNG PEOPLE

Learn more about our neighborhood at regentneighborhood.org

ADULT #1

ADULT #2

Questions? New to the neighborhood? Contact Jon Miskowski at jonmiskowski@gmail.com

B O P S Y B O P S Y

NOTE: Children's job interests will not be carried over from last year, so please provide updated information.

Help plan activities Become Block Captain or Area Rep.

Help plan activities Become Block Captain or Area Rep.

Thank you! Your involvement keeps our neighborhood thriving!

Jobs (Circle) Jobs (Circle)

B O P S Y

Annual RNA Membership CampaignJune 2017 – May 2018

Join or Renew Today!

B - Babysitting O - Odd Jobs P - Pet Walking S - Snow Shoveling Y - Yard Work

Jobs (Circle) Jobs (Circle)

Deadline to receive and be listed in the RNA Directory is July 31.

MEMBERSHIP INFORMATIONSTREET ADDRESS (required) _________________________________________ PHONE ___________________ ZIP 537____