Community Organization Form

Please provide the following information and mail it to:
 
        RockNet
        111 Maryland Ave.
        Rockville, MD 20850-2364


Name of Community Organization: ______________________________________________

Purpose and Activities: ______________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Membership (number of members, who can belong, dues): ________________________

______________________________________________________________________________

______________________________________________________________________________

Meetings (where, when): ______________________________________________________

______________________________________________________________________________

Newsletter (frequency, name): ________________________________________________

______________________________________________________________________________

Contacts:

name               address            phone        fax        e-mail

______________________________________________________________________________
President

______________________________________________________________________________
Vice President

______________________________________________________________________________
Treasurer

______________________________________________________________________________
Newsletter Editor

______________________________________________________________________________
Web Page Author

______________________________________________________________________________
Other Contact


Authorized by:  ____________________________________  Date: __________________

Organization position:  ____________________________