City of Edina Home Page
Edina, Minnesota
 

Membership Order Form



Membership Type: Select the checkbox that describes your membership.
 

Individual

Couple (two people residing at the same address)
 
First Person:
  Are you at least 55 years old? Yes
No
 
  Have you been a member before? Yes
No
 
 
 
Membership Names: Provide each member's name and birth date.
 
Name(s): Birth date (mm/dd)
 
Mailing Information: Tell us where to mail your newsletter.  The red asterisk (*) indicates a required field.
 
* Name:
* Street Address:
* City:
* State:
* Zip:
* Phone Number:
  Winter Address if gone for more than three months:
 
 
* I understand that some of the information provided on this form will be public data. Public data is available to anyone who makes a request for such information. My credit card number is not considered public data.