TOWNS COUNTY CIVIC ASSOCIATION
Post Office Box 455, Hiawassee, GA 30546-0455
Website: www.townscountycivicassociation.com Email: [email protected]
Date: ____________________________________
Name(s) ________________________________________________________________________ __________________________________________________________________________
Residency: Full-time ___ Part-time ___ (*if part-time please complete both address sections)
Towns County mailing address: _________________________________________________________________ City: _____________________________Zip Code:____________
Email: _____________________________________________________________________ _______________________________________________________________
Phone Numbers: Home (________) _______________________________________ Cell (________) ________________________________________________
*Part-time Residents’ Home Address:
______________________________________________________________________________________________________________________________________________________________
Dues: $25.00/year for both Individuals and Families, July 1 to June 30 of each year. The enclosed payment is for which year(s): ______________________
This section to be completed by Association Officer or Director
Paid by: Check # ________ Cash $_________ If cash was a receipt issued ________
Date received: ____________20____ Date deposited: ___________20____