Moss Bay Neighborhood Association

Annual Dues (optional)

Annual dues for the Moss Bay Neighborhood Association are $15. The money is used for association
activities, paperwork expenses, hospitality, and procuring materials such as meeting notice signs.
Dues are optional. If you would like to join, but can't pay dues at this time, simply fill out this form
and mail it in. The association is open to all residents and property owners in the Moss Bay
Neighborhood.

Please print this form and mail it with your check, payable to:

Moss Bay Neighborhood Association
Leslie Keller, Treasurer
435 7th Ave South #A
Kirkland, WA 98033

Your Name __________________________________________________________

Street Address _______________________________________________________

City, State, Zip ______________________________________________________

Phone ______________________________________________________________

email _______________________________________________________________

Areas I'm willing to help:
_________________________________________________________________________________

Paid Amount ______________________________

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