Hotspots Survey for Neighborhood Clean Up

Work Description(s) and Location(s): _________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

Estimated manpower, tools and equipment: _____________________________________________________

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Will you be available for contact? _____________________________________________________________

Will you available to supervise during cleanup? ___________________________________________________

Name: ______________________________     Telephone: ________________________________________

Membership Renewal

Name(s): ________________________________________________________________________________

Company: ________________________________________________________________________________

Address: _________________________________________________________________________________

Home Phone: __________________________     Work Phone: _______________________________________

Dues: _____ Resident $15    _____ Business $25      _____ Senior Citizen $2

_____ New Member     _____ Renewal

Please make checks payable to "CSNA"