Membership Application 2010
Rocky Point Civic Association
P.O. Box 341
Rocky Point, NY 11778
(Adobe PDF Version)

The Rocky Point Civic Association is a non-profit group of volunteers and concerned citizens whose mission is to improve the quality of life in Rocky Point and neighboring areas. With your support, we can continue our work on behalf of the entire community. Membership is $10.00 per person and $15.00 per family for the entire year and mail it to the address above OR return it in person at our next civic meeting. An individual who has reached the age of eighteen years and who is a resident of Rocky Point shall be eligible for membership. One or more members of each family may join.

Name: ____________________________________________________

Address: __________________________________________________

City, State, Zip: ____________________________________________

Phone: ____________________________________________________

Fax: ______________________________________________________

E-Mail: ____________________________________________________

Here is my payment of $_________________representing my dues.

Please check one below:
[ ] I am a new Member. [ ] I am a renewing Member