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CIVIC ASSOCIATION REGISTRATION
PLEASE RETURN FORM TO:
NEIGHBORHOOD SERVICES
City of El Paso, Department of Community + Human Development
City 3 801 Texas Ave., 3
rd
floor
El Paso, Texas 79901
Phone: (915) 212-1681
Email: NeighborhoodServices@elpasotexas.gov
CHECK LIST: Include the following materials with Registration Form
Copy of signed by-laws (bylaws must contain previsions as stated in the City’s Neighborhood
Association Recognition Ordinance No. 017744)
Copy of membership list of 100 or more individuals (names and addresses)
Copy of signed E-mail Release Consent form (Optional)
DATE: ____________
1. Name of the Civic Association:
_____________________________________________________________________________
2. City Planning Area the Civic Association is requesting City Notices for:
Central Eastside Mission Valley Northeast Northwest
3. City Representative Districts the Civic Association covers:
Districts: ____________________
4. Civic Association Contacts to Receive City Notices:
(Email provided is solely for the purpose of communicating with the City of El Paso electronically. It is confidential
under State Law unless you affirmatively give consent in writing for public release. You may provide affirmative
consent at the end of this document under “Email Release Consent”.)
First Person Point-of-Contact
Name: ______________________________________________________________________
Position (Officer or General Member): _____________________________________________
Mailing Address: ______________________________________________________________
Zip Code: ____________
Phone Number(s): _____________________________________________________________
E-Mail Address: _______________________________________________________________
Second Person Point-of-Contact
Name: _______________________________________________________________________
Position (Officer or General Member): ______________________________________________
Mailing Address: _______________________________________________________________
Zip Code: __________________________________________________________________
Phone Number(s): ___________________________________________________________
E-Mail Address: _____________________________________________________________
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5. Elected Officers/Board Members of your Civic Association: (Include titles and attach
additional page, if needed)
Name:
President Coordinator Captain Director Other ______________
Name:
Vice-President Co-Coordinator Co-Captain N/A
Name:
Secretary N/A
Name:
Treasurer N/A
Name:
Other ______________________
6. How long has the Civic Association been in existence? (Date of first meeting)
7. Where and when does the Civic Association usually meet?
Monthly Quarterly Annual Other: __________________________
Location:
Day of calendar month: (ex: 1
st
Mondays of the month)
8. If the Civic Association has a web site, please list it below:
____________________________________________________________________________
9. Statement of Purpose for the Civic Association:
____________________________________________________________________________
10. If the Civic Association has neighborhood/community priorities on which to
concentrate, please list these objectives: (Attach additional page, if needed)
____________________________________________________________________________
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Email Release Consent
I, _________________, (Printed Name of 1
st
Contact of Neighborhood/Civic Association) affirmatively
consent to the release of my email address, which is listed below, by the City of El Paso, Texas, until
such time as further written notice is provided to the Neighborhood Services Division.
_______________________________________________________________________________
Email Address
_________________________________________ __________________________
Signed Signature Date
Alternatively, by electronic consent:
By checking this box, I affirmatively consent to the release of my email address.
I, ________, (Printed Name of 2
nd
Contact of Neighborhood/Civic Association) affirmatively consent to
the release of my email address, which is listed below, by the City of El Paso, Texas, until such time as
further written notice is provided to the Neighborhood Services Division.
_______________________________________________________________________________
Email Address
_________________________________________ __________________________
Signed Signature Date
Alternatively, by electronic consent:
By checking this box, I affirmatively consent to the release of my email address.
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