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Silver Beach Association

PO Box # 3

Normandy Beach, NJ 08739

Member’s Name and Permanent Mailing Address:

Member Name: _______________________________________________

Additional Name: _______________________________________________

Winter Street Address: _______________________________________________

Winter City: ___________________ State: _________Zip __________

2010 SEASON		Amount Paid
Annual Dues (required)	$350 per house	$ 350
2010 Assessment (required)	$100 per house	$ 100
New Membership Initiation Fee (new Members only)	$700 per house
Extra Homeowner Badges	__ x $20 per badge =
Tennis Membership Fee	$75 per house
Recreation Donation
“Old Yeller” Bay Beach Slide Donation
Late Fee if Dues & Assessment paid after 6/12/10	$50
	Total

Please note any address changes/corrections directly on this form.

Silver Beach Street Address: _____________________________________

Summer Mailing Address: (Only if you use a temporary mailing address in the summer)

Street Address: ______________________________________

City: ____________________ State: __________ Zip: __________

Silver Beach Phone: Area Code: ______Phone #: ______-________

Winter Phone: Area Code: _______Phone #: ______-________

Cell Phone/Emergency Phone: Area Code: _______Phone #: ______-________

Email Address (Only if you wish to receive ALL mail via Internet): ___________________________

If you are interested in becoming involved in these activities, please provide the requisite information below:

	EXECUTIVE COMMITTEE	ENTERTAINMENT COMMITTEE	STREET CAPTAIN	SATURDAY NIGHT AT THE MOVIES	GOLF OUTING (Include # Players)
Name(s)
Phone Number
Email (if applicable)
How would you like to participate?