Membership Form

Dues: $15 for single, $35.00 per family

(Pay before June 1, and get $5 discount for family membership)

Dues and donations go toward the annual picnic in the spring, the oyster roast in the fall, and annual contributions to Shiloh School, and Hughlett Point Natural Reserve.

Name*: __________________________________________________________

Mailing Address*: __________________________________________________

Alternate Mailing Address ___________________________________________

Telephone Number*: ________________________________________________

Alternate Telephone Number: ________________________________________

Email Address (VERY IMPORTANT)*: _________________________________

Alternate Email Address: ____________________________________________

* = REQUIRED
____________     I am interested in serving as a Board Member.

Please contact me by (check preferred means of contact) Email_____ Phone_____

Please print this page or download the PDF & mail your dues with the form to the following address:
Dividing Creek Association
P.O. Box 1234
Kilmarnock, VA 22482

       Join Our Board

The Association is always looking for members to serve as Board Members or on special committees. If interested in finding out more, please email Craig Keeler for more information.