HOMEOWNER REGISTRATION FORM

Please provide us with your contact information as well as emergency contact information should we need to get in touch with you for any reason.

The Ponderosa Community Club Office
21100 Cayuse Street
Leavenworth, WA 98826

Name of owner(s):  ___________________________________________________

Ponderosa address: __________________________________________________

Previous owners(s): __________________________________________________
 
Owner(s) home/billing address: _________________________________________

City: _________________________________ State: __________   Zip: ___­­­­­_____

Home phone number: _______________________________

Alternate phone number: ____________________________ (in case of emergency)

Would you like to be included on our Ponderosa List Serve—blind copies—for relevant news?  

YES or  NO  [ circle one ]

Would you like to receive an electronic version of the NEEDLER?

YES or  NO  [ circle one ]

If yes, email address:  ________________________________________

Any concerns or questions? 

• The Ponderosa office phone/fax number is:  (509) 763-0320
• The Ponderosa website is:  www.ponderosacommunityclub.org
• Email address: pccoffice@nwi.net