2017 Wilsonia Village Contact Information & Dues Form
Please provide your name, cabin address and phone numbers that you would like to have called in the event of an urgent or emergency situation in Wilsonia. Note: If there is no cabin phone, please provide a phone number that may facilitate notification of a cabin user in the event of an evacuation or other emergency situation.

Please also provide your mailing address and the names of owners, co-owners or principle users as applicable
Your Name *
Cabin Street Name *
Cabin Address Number *
5 digit number beginning in 83 or 84
Cabin Phone Number *
a land line dedicated to the cabin (559) 335-xxxx. If none, enter "none".
Emergency Contact Phone Number - in WIlsonia *
Other than dedicated cabin phone number. May list multiple numbers
Emergency Contact Name *
someone else to call in case of an urgent or emergency situation
Emergency Contact #2 Name & Phone Number *
or other numbers to contact you or a family member or loved one
Emergency Contact #3 Name & Phone Number
or other numbers to contact you or a family member or loved one
Other information or contacts
please list and describe
Your email addresses *
if no email, type none
Your Mailing Address *
City *
State (example CA) *
Zip Code
Newsletter Preference
cabin dues include one newsletter subscription (postal or email) add'l email subscriptions can be requested free of charge from the website or list below
Are you the owner? *
Required
Owners name(s) - for cross reference
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