Russian Hill Neighbors

Russian Hill Neighbors Membership Form

To pay online via PayPal, click here

To apply for membership, print this form, fill it in and
send your check for membership fee to:
Russian Hill Neighbors
1819 Polk Street, #221
San Francisco, CA 94109

Join Russian Hill Neighbors Today! Please check one: Renewal _____ /New Member _____ DATE ____________
Are you interested in volunteering on any of the following committee(s)? If so, please indicate with one or more checks. (Committee descriptions can be found on the webpage at www.rhn.org under committees)
__ Neighborhood Improvement __ Traffic and Transportation __ Design, Zoning, and Land Use	__ Social (dinners, happy hours) __ History __ Families with Children __ Safety/NERT/AWARE	__ Annual RHN Event __ Membership __ Communications/Marketing
Are you interested in volunteering a day or two during the year for RHN activities? Yes_____

Name #1 __________________________________ Name #2 ______________________________________

Address __________________________________ City __________________ Zip Code _____________

Home Phone _______________________________ Work Phone ____________________________________

E-mail #1 __________________________________ E-mail #2 ______________________________________
(Provide e-mail only if you wish to receive e-mail bulletins from RHN. Please print legibly)

Enclosed is my tax deductible membership dues of:

__ $20 Seniors __ $25 Individual __ $35 Household (two or more people) __ $40 Merchant

Additional tax deductible donation: General Fund $______ Fay Park $______ Helen Wills Park $______

Broadway Tunnel Project $______ Sterling Park $______

Number in Household: ___ Under 18 years ___ 18-30 years ___ 31-50 years ___ 51-64 years ___ 65 or older

Memberships expire December 31 each year. However, if you joined RHN as a new member after September 1 your membership is paid through the end of the following year. Thank you for your continued support!

Please make checks payable to “Russian Hill Neighbors.”

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