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Upper East Association Member Information and Survey
Email address *
This form will allow us to update our records with your current household information. At the end is a three question survey that will help UEA better serve its members and our neighborhood. If you are now a member, just fill in information that has changed, but please complete the survey at the end.
Name (household member 1)
Your answer
Name (household member 2)
Your answer
Please indicate whether you are a new member or a current member *
Address (in UEA neighborhood) *
Your answer
Zip (in UEA neighborhood) *
Your answer
Telephone number(s)
Your answer
Mailing address (if different from above)
Your answer
City, State (if different from above)
Your answer
Zip (if different from above)
Your answer
Email address (household member 1)
Your answer
Email address (household member 2)
Your answer
Telephone number (household member 1)
Your answer
Telephone number (household member 2)
Your answer
Survey question 1: Please suggest any important actions/activities you would like to see the Upper East Association involved in.
Your answer
Survey question 2: May we contact you to assist our efforts to prepare for an emergency affecting our neighborhood?
Survey question 3. Other comments, questions, or suggestions?
Your answer
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