Your Name _____________________________________________________________________

Street Address ___________________________________________________________________

City ___________________________________________ St. ____________ Zip ______________

Please fill out the form and mail it, along with a $5.00 yearly dues fee* to:

Hartwell Improvement Association

PO Box 15608

Cincinnati, Ohio 45215-0608  

The membership director will then mail your membership card to you.  

**Please make checks payable to: The Hartwell Improvement

Membership Form