Montgomery Square
Citizens’ Association
PO Box 34811
Bethesda, MD 20827
2015 Dues & Information Form
Dues $50
Please return this form with your dues payment
The below information is for the MSCA Directory and e-announcements. MSCA distributes a paper
directory every two years. 2015 is an off year, but MSCA will make available a PDF copy this
summer. Please make changes or additions to the below info. If there is no info listed and you would
like to be in the directory or receive e-announcements, please complete.
Directory information comes from the returned forms. E-announcements can only be sent to
households that provide an email address. Questions - Contact Steve Schuck at
[email protected] or call 301-580-0177.
#1 First Name:
Last Name:
#2 First Name:
Last Name (if different):
Address:
Phone #: (we only print 1 number)
Children (birth year optional):
Email 1:
Email 2:
If your child would like to be listed in the Youth Services Directory please give:
Name, Age and Service Provided (babysitting, snow removal, yard work, music lessons, tutoring, etc.)
Add our house to the MSCA Free Tree Program List - Yes No Already On List Already Planted
MSCA Comments/Feedback – please use back for more room
Annual Dues are $50. Additional Contributions are always welcome. A return envelope is
enclosed. Neighborhood dues are used to pay for: Landscaping & Maintenance to five entrance areas
of Montgomery Square, Newsletters, Neighborhood Directory, MSCA website, Social Functions, EAnnouncements, Yard Sale ads, and other agreed upon expenses. Make checks payable to: MSCA
Thank you for your support!
Return to:
MSCA, Inc.
PO Box 34811
Bethesda, MD 20827
Amount paid: __________
or drop off at: Roger Hahn’s
11906 Smoketree Rd