Palisades Pool Application Form

Name (s) ___________________________________________________________________

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Address:

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City State ZIP

Phone: ___________________________________________________________________

home work

Email: ___________________________________________________________________

I am applying for membership to Palisades Swimming Pool Association, Inc. I have enclosed a non-refundable application fee of $40 payable to Palisades Swimming Pool Association, Inc. My cancelled check is my verification that my application was received. I understand my name will be placed on the waiting list, and it is my responsibility to notify Palisades of any change in address.

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Signature of Applicant

Mail to: Palisades Swimming Pool Assoc., P.O. Box 636, Glen Echo, MD 20812.