Contact Info:
*First Name :
*Last Name :
*Phone Number :
*Email address :
Board Member :	Select Yes No
Position :
Community Info:
Name of Community :
Address of Community :
Year established :	Select a year 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950
Total number of homes/lots :	Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100
Monthly dues assessment per home/lot :	$
Amenities:
Park :	Select Yes No
Pool :	Select Yes No   How many ? : Select 1 2 3 4 5 6 7 8 9 10
Clubhouse :	Select Yes No
Ball Field :	Select Yes No
Electronic Gate :	Select Yes No   How many ? : Select 1 2 3 4 5 6 7 8 9 10
Current management contract expires on
Enter the code shown above :	(case sensitive)