Name *

First Name

Last Name

Phone *

(###)

###

####

Spouse/Partner Name

First Name

Last Name

Phone Spouse/Partner

(###)

###

####

Address *

Please provide your Rim Area Property Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Support for Permit Parking District

Please indicate if you support the creation of a PERMIT PARKING DISTRICT for residents and their visitors in the Rim Area Neighborhood.

I DO support the Permit Parking District.

I do NOT support the Permit Parking District.

I am Applying for membership as a: *

Please indicate the level that best fits your HH or Business:

$10 Student

$25 Renter/Single

$50 Family

$100 Small Business

$250 Corporation

$250 Founding Member

Other