Hungary Creek Recreation Association
Membership Application
Year 2012

The undersigned hereby makes application for membership in Hungary Creek Recreation Association, a non-stock association, and agrees that if the application is accepted, he/she will abide by and comply with the by-laws and all rules and regulations heretofore or hereafter adopted by said association.

The non-refundable price of said membership is $600.  In addition, you are required to pay the first year's dues of $375 for a total of $975 due at the time of the application.

In the event this application for membership is rejected, any sum advanced by the applicant toward payment of all or part of the membership fee will be returned to said applicant together with any note evidencing all or any part of said fee, which shall be marked "Cancelled".

Upon acceptance by the association of this application, the person in whose name the membership is recorded shall be entitled to one vote at all annual, regular, and special meetings of the members of said association.  A copy of the application will be returned to you for your records.  Failure to pay the required annual dues will result in forfeiture of membership. 


Please furnish all of the following information:
	
	Last Name	__________________________	Home Phone	_________________	

	First Name	__________________________	Work Phone	_________________

	Spouse's Name	__________________________	Work Phone	_________________

	Address	 _______________________________ 	City	_____________ 	Zip	___________

   Unmarried children of above person(s) living at above residence:

            First Name		Last Name	Birth Date
  ________________________	_________________________	____/____/____
  ________________________	_________________________	____/____/____
  ________________________	_________________________	____/____/____
  ________________________	_________________________	____/____/____
  ________________________	_________________________	____/____/____
  ________________________	_________________________	____/____/____



Do not Write below this line (for HCRA use only)

This application handled by: ______________________________________  Date: ________________

Amt: ____________________   Check # __________________

Notes:______________________________________________________________________________