The Scottsmoor Community Association
Membership Application

Date:
Name:
____________________________ Please check Appropriate: ___ Land Owner ___Resident Street Address:__________________________________ Mailing Address:______________________________ City & Zip:____________________________ Phone#:_______________ E-Mail:__________________________________ Activities you would like to see offered at the Scottsmoor Meeting Hall (for a small fee) ___________________________________ Activity YOU are qualified and willing to teach or lead: ___________________________________ Local Concerns:___________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ Dues are $10.00 per adult family member and are due annually In January. For office use only – PAID yes no Mail this application to: Scottsmoor Community Association P.O. Box 657 Scottsmoor, FL 32775 Please be aware that we will charge a for any returned checks based on our bank's returned check fee. Want to advertise on our website at www.Scottsmoor.org ? Members pay only $15 to have an ad on our website for one whole year!