________Voting membership - Eligibility: Adult individuals who reside in or own land in Coral Bay Quarter or East End Quarter
_______ I am a bone fide resident, as stated above. # of years _______
_______ I own land, in area as stated above. Parcel # _______________

_______ Supporter - Eligibility: Individuals and Organizations who want to stay informed about CBCC and local issues.
Will receive any general membership mailings and may attend all public meetings and participate as volunteers.
Name: ______________________________________________________________
Mailing Address:_______________________________________________________
Physical address, if different:______________________________________________
Phone numbers (home__________, work,___________ cell___________________)
E-mail address: _______________________________________________________
My main issue interests are:
____________________________________________________________________
The most important Coral Bay Issues are : _________________________________________________________________

Dues: $20.00 per individual membership, Additional donations are always appreciated, and needed for our work.
Dues: _____________ Donation:______________
Please make checks payable to Coral Bay Community Council.
CBCC is a 501(c) (3) nonprofit organization. Dues and donations are tax-deductible.

___________________________signature

Mailing Address: 9901 Emmaus, St. John, VI 00830-9587
Phone/fax: 776-2099
Office: 8-1 Estate Emmaus, Coral Bay, in the Town & Country Bldg. (above K-2
Video, across from Skinny Legs)
Email: coralbaycommunitycouncil@hotmail.com