Smart PDF Form

The Chipita Park Association (CPA) is a neighborhood association registered as a 501(c)(4) nonprofit organization. Membership is open to anyone who owns property in, resides in, or has an interest in the Cascade, Chipita Park, Green Mountain Falls area. Annual membership dues are $60 per household or $35 for an individual and cover the calendar year. Members will receive newsletters and email communications regarding CPA activities and may participate in management of the Association.

Name (1)

First NameLast Name

Ute Pass (Local) Address

Email Address

example@example.com

Phone Number

Mailing address if different than above

Contact information for other adults included in household membership:

Name (2)

First NameLast Name

Email Address

example@example.com

Phone Number

Name (3)

First NameLast Name

Email Address

example@example.com

Phone Number

Contact information will be published in the annual membership directory and shared with other members unless you choose to opt out by indicating:

Please do not publish my:

nameaddressemail addressphone number

Membership for Calendar Year: Household $60 or Individual $35

Additional Donation: (while not tax deductible, it is appreciated!)

Advertising in the directory: $20 to include your business card info

Advertising on CPA website: $10 to post your business card info

Total enclosed:

Completing the application online will send the information to CPA's email account. Must be received by March 15 to be included in the membership directory. Membership directories are typically distributed in person during the first potluck social but will be mailed in July to anyone who has not picked up. Updates to the directory will be distributed at intervals later in the year as new members continue to join.

CHIPITA PARK ASSOCIATION

Suggestions for CPA