Office Staff

	COMMUNITY	Consists of manufactured home communities.
	SERVICES & INDUSTRY MEMBER	Consists of those persons, and/or firms involved in or supportive of the manufactured housing industry.
	PROVISIONAL MEMBER	Consists of those communities in the planning stages or under construction. Membership in this category shall be converted to a full Membership upon occupancy of 70% of completed spaces.

COMMUNITY OR PROVISIONAL MEMBER INFORMATION

/COMMUNITY INFORMATION/- Consists of manufactured home communities.

Community: No. of Spaces:

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Address: County:

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City: State: Zip:

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Phone:

Manager:

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OWNER/MANAGING AGENT INFORMATION

Name:

Owner:

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Mng. Agent:

Address:

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City: State: Zip:

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Phone:

MEMBERSHIP INVESTMENT

Total # of spaces @ $7.00.......................................................	$
$500.00 for Provisional Member or $250.00 for Service and industry Member...............................	$
*PAC Contribution...................................................................	$
Amount of Check Enclosed.....................................................	$

Application agrees to uphold MHCO Code of Ethics and to maintain membership in good standing.

/ _____________________	/ ______________________________________________
Date	Authorized Signature

*POLITICAL ACTION COMMITTEE (PAC). Contributions to the MHCO Political Action Committee will be used to promote sound legislation, fight radical legislative proposals and support local and state political leaders who foster the growth of our industry. Although there Is no minimum or maximum contribution, each member is asked to contribute $2 per space to this Important program. Check with your tax advisor for tax credit/deduction information.

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Total Spaces _@ $4.00 per space =$

SERVICE & INDUSTRY MEMBER INFORMATION

Company Information - Consists of those persons, and/or firms involved in or appropriate of the industry

Firm Name:

Street Address:

City: State: Zip:

Phone: County:

Contact:

DESCRIPTION OF COMPANY SERVICES - Describe service(s) provided and/or type(s) of product(s) sold.

MEMBERSHIP INVESTMENT

Annual Dues .................................................................	$
*PAC Contribution..........................................................	$
Amount of Check Enclosed............................................	$

I certify that neither this firm nor any of its principals own any manufactured home communities or recreational vehicle parks. Should ownership be acquired, the Association will be notified and the appropriate application submitted.

______________________	_______________________________________
Dated	Authorized Signature

After filling out the above form please print, sign and mail, along with your check to:

Manufactured Mobile Home Owners-NV
4050 S. Spencer, Suite 107
Las Vegas , NV 89119