Civic League of Pembroke Meadows, Inc.
DATA SHEET FOR COMMUNITY DIRECTORY
The Civic League maintains a community directory on the web for use by residents. 
Please complete the following form to help us keep your information up-to-date.
 
*  Fields that must be filled in
To: 
 "Membership File Manager" <pmcl@cox.net>
Subject: 
From: * 
 * 
 Your Last Name     Your First Name and Initial
Email: * 
     Example:johndoe@cox.net 
    (For Community info only: Will not to be dispersed, sold or marketed)
Re-Enter 
Email: * 
Address: * 
Phone: 
Cell Ph:
Occupation:
Spouse/ 
Partner:
 
 Last Name  First Name and Initial
Others In 
Household: 




How to 
List in 
Website
Directory:
Name: * 
Phone Number: * 
Email Address: * 
Full Name and Initials of person giving info and permission to post Information
 * 
 * 
Full Name     Your Initial as your signature
Comments: 
Dues:  If you already paid your Pembroke Meadows Civic League dues, just click the "Send Email" button below.
If you haven't paid this year, now is an excellent time!
 
Just print this form, write your check for $10.00 to "PMCL" and mail to:
Civic League,  P.O. Box 68052,  Virginia Beach, Virginia  23471
00207