Print this form, fill it in, and mail with your check or money order to:

Willow Glen Neighborhood Association
Post Office Box 7706
San Jose, CA 95150-7706

[ ] Individual Membership ($10 for 1 year, $25 for 3 yr, $40 for 5 yr);
[ ] Household ($20 for 1 year, $50 for 3 yr, $80 for 5 yr);
[ ] Associate ($20 for 1 year, $50 for 3 yr, $80 for 5 yr) (non-voting membership for residents outside the Willow Glen area)
[ ] I want to make the following additional donation: ______________ (thanks!)

NAME: ______________________________________________________________

STREET: ________________________________________________ APT._______

CITY/STATE/ZIP: _____________________________________________________

DAY PHONE: (_______)__________________ EVE: (_______)_________________

EMAIL ADDRESS: ______________________________________________________

I/we are especially interested in:

[ ] airport noise; [ ] art; [ ] bike routes; [ ] emergency preparedness; [ ] graffiti abatement;
[ ] parks & rec.; [ ] schools; [ ] traffic/parking; [ ] tree plantings; [ ] zoning/land-use.

Get involved! We invite you to participate in any of the following activities:

[ ] Assist with WGNA's newsletter (writing, assembling, mailing)
[ ] Neighborhood "clean-up’s" and beautification projects.
[ ] Graffiti paint out.
[ ] Tree plantings.
[ ] Willow Glen Founder’s Day Volunteer.
[ ] Special event volunteer.
[ ] History of Willow Glen.

Memberships can also be paid via PayPal. Send your payments to treasurer@wgna.net. Be sure to add in your name, address, and other information in the ‘notes’ section. If you have any questions on the above options, please feel free to email the Treasurer at treasurer@wgna.net.

updated 10/21/07 LLA