Property Owners of Eaton’s Neck Beach, Inc

                                                  2008 Membership Registration Form

   (Please fill out the Information below and return with your check payable to POENB to the Address below)

    Name      ___________________________________________________________

    Address  ___________________________________________________________

    Telephone_____________________E-Mail_________________________________ 

    How Many Dinghy Stickers would you like for  Price's Bend _____________ at $25 each

   How Many Kayak Sticker for Valley Grove_______ at $25each                                                                                                                                              2008 Membership Rates    Senior (62 or Older):  $100_____        

                        Standard Rate  Senior (62 or Older):  $110___

       New Resident (within the last 6 months):  $100____                                                               

                  Committees/Events you are interested in participating in:

      Beach Committee   _____   Egg Hunt _____ Social Committee _____  Parti Gras _____ 

      Garden Club ____ Block Captains  _____  Adult Beach Party _____  Membership  _____  

      Children’s Summer Workshop _____ Fourth of July Parade _____  Chowder/Chili Fest _____

      Changing Tides____ PastaParty   _____ NewYearsEveParty____TagSale_____Halloween____     

      Suggest an Event: ____________________________________________

    Please accept my donation of $______________ towards the POENB Scholarship Fund

      Please Return this form with a check to: POENB, P.O. Box 124, Northport NY 11768