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Palisades Pool Application Form

 Name (s)    ___________________________________________________________________

                  ____________________________________________________________________
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.