Name

Email

Street Address

Phone

I would like a:
Individual Residential Membership ($20 annual dues)Dual Residential Membership ($30 annual dues)Commercial Membership ($50 annual dues)

If selecting Dual Residential Membership, please complete the following:
Name of Second Member (required, if applicable)

Email of Second Member (required, if applicable)

Phone of Second Member (if applicable)

Donation:
Yes, I would like to make a donation to the EPNA.No thanks, I would not like to give a donation at this time.

If Yes, donation amount:
Please *do not* include the dollar sign. Example of proper format: 20.00

I am interested in helping with the following committees and activities:
Tour of Homes and GardensBeautificationEducationHistoryMarketingMaster Plan/GovernmentMembershipMerchandiseNeighborhood WatchNews/Flyer DeliverySpecial EventsWelcomingOther

If Other, please explain:

Payment

When you Submit this application, you will be redirected to PayPal to submit your payment.

If you prefer to pay by check, please Submit this form, then send your check payable to EPNA to:
Elmwood Park Neighborhood Association
Attn: Membership Committee
PO Box 7665
Columbia, SC 29202

The Elmwood Park Neighborhood Association is a 501(c)(3) organization and your donation may be tax-deductible to the maximum extent allowed by law.