Please Print this Form and mail it along with your check to the Association Office:

SIDEWALK MAINTENANCE/AVENUE BEAUTIFICATION
CONTRIBUTION FOR CURRENT MONTH OF 1999.

Monthly contributions towards funding our West Portal Avenue private sidewalk maintenance and Avenue beautification: Sidewalk maintenance is a merchant issue, not a Merchant Association issue and your contribution to this service would be greatly appreciated. Please print the following form and mail your monthly $10.00 contribution to:

WEST PORTAL AVENUE ASSOCIATION
Beautification
236 West Portal Avenue, # 313
San Francisco, CA 94127-1423

Enclosed please find a check in the amount of $10.00 for my sidewalk cleaning contribution for ______________, 2000.

Business Name: __________________________________________________________

Contact:_________________________________________________________________

Address:_________________________________________________________________

Phone Number: _________________________________