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Use PayPal

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(New residents to
Cumberland Hill
who have moved
in after October 1st
should not
use PayPal.
Use this form to
pay the pro-rated
amount by check)

Click here to print this form

Name__________________________________________________________

Spouse________________________________________________________

Child __________________________________________________________

Child __________________________________________________________

Address _______________________________________________________

Phone ___________________________________________________

E-Mail _________________________________________________________

Are any of your children interested in offering the following services?
If so, check and list child’s name.

____ Child Care ________________________________
____ Lawn Care ________________________________
____ Snow Removal _____________________________
____ Pet Care __________________________________

Would you like to be added to the CHNA email list?

____ Yes ____ No

Do you have an interest in becoming active with CHNA? ___YES ___ NO

Committees:
___ Directory              ___ Landscape
___ Newsletter            ___ Ombudsman
___ Social/Activities    ___ Welcome

DUES: $49.00 / year (July--->June)

Pro-rated dues if paid mid-year: (FOR NEW CUMBERLAND HILL RESIDENTS ONLY)
Paid in October-December - $40
Paid in January-March - $28
Paid in April-June - $49 applied to next year’s dues

Please make check payable to: CHNA

Send to:
CHNA
P.O. Box 24985,
Lexington, 40524

THANK YOU!!