MITCHELL-LAMA RESIDENTS COALITION, INC.

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JOIN THE MITCHELL-LAMA RESIDENTS COALITION, INC.

Please print form, enter information and
Mail to:  MLRC,  P.O. Box 20414,  Park West Station, NY, NY  10025

INDIVIDUAL $10.00 Per Year -
DEVELOPMENT 15 cents Per Apt. ($25 Minimum; $100 Maximum)

Name____________________________________________

Address__________________________________ Apt # ____

City_______________________ State_______ Zip Code______

Evening Phone_____________ Day Phone___________________

Fax________________ E-Mail ___________________________

Development__________________ Check: Renewal_____ New Member_____

MLRC Fights for you and your right to affordable housing!