PRA Directory Form:

The Parkwood Residents Association - a nonprofit organization dedicated to addressing issues affecting our neighborhood - will be publishing a directory of and for Parkwood residents in 2003. This directory will include basic information (adults' names and address - this information is currently publicly available) unless you notify us in time that you do not wish to be listed. In addition, the directory will include supplemental information for those residents who return this form.

Please complete the information that you would like to be included in the Directory. If you do NOT wish to be listed at all, please complete your street address and check the box at the bottom of the page.

Street Address: _______________________________________________________

Adult Residents: ______________________________________________________

Home Phone: _______________________Work Phone(s): _______________________

E-mail Address(es): ______________________________________________________

Fax Number: ______________________________________________________

   Name    Age Grade School Attended

check here if you do not want to be included I do not wish to be included in the Parkwood Residents Association Directory.
Please return this form ASAP to Kitty Stone:
     Address:    4313 Clearbrook Lane      Fax:    301/564-9574