FICRA Building Trust Membership Registration/Renewal

We welcome local residents to help support community events sponsored by the FICRA Building Trust by paying annual event dues of just $25. Membership dues are for the year beginning August 1st and ending July 31st. Dues paying members attend some events for free and pay lower prices for other activities sponsored by the Trust.

Instructions for using this Form

This online form may ONLY be used if you are able to pay online via PayPal. You do not need to have a PayPal Account to use their payment service. When you click the button at the bottom to submit this form, you will be directed to a PayPal payment screen. If you click the Pay with Debit or Credit Card link at the bottom of the PayPal screen, you can pay without signing up for an account. DO NOT USE THIS FORM if you are unable to pay online via PayPal. If you can not pay online, you should download and print out our form, complete it and mail it with your payment to FICRA Building Trust at PO Box 25, Fox Island, WA 98333.

If you see a red asterisk (*) next to a field name, you must fill out that field with the correct information or you will be unable to submit the form. If the form is rejected because the required information was not included, you may have to fill out some of the fields all over again.

Please note that this online form is difficult to fill out on a phone screen, since the layout may change. We strongly recommend you use a desktop system or large tablet. (Hint - when filling out this form, you can use the tab key on your keyboard to move to the next field.)

PRIMARY MEMBER

First Name & MI *

Last Name *

Primary Phone Nbr *

Addl Phone Nbr

EMail Address *

Please check all applicable boxes:

I Live on Fox Island

I Do Not Live on Fox Island

I Own Property on Fox Island

Residence Address *

Please do not enter a PO Box in this field. This field is used to determine if you reside on Fox Island or somewhere else.

City *

City

State *

State

Zip Code *

Zip Code

Do you have a separate mailing address? *

Yes

No

Provide a mailing address that you would prefer we use instead of (or in addition to) your residence address.

Mailing Address

Mailing City

City

Mailing State

State

Mailing Zip Code

Zip Code

Is there another person in your household? *

Yes

No

ADDITIONAL HOUSEHOLD MEMBER

Please complete this section if there is an additional person in your household that shares your membership.

Addl First Name & MI

Addl Last Name

Addl Phone Nbr

Addl EMail Address

VOLUNTEERING

Are you interested in doing more to help out your community?

I am interested in:

Organizing activities/events

Helping out at activities/events

Helping with the newsletter and other communications

Joining the Citizen Patrol

OtherOther

PRIVACY

The information you provide to the FICRA Building Trust is used solely for FICRA Building Trust purposes, which includes member communications, emergency planning and notifications. The Trust also publishes a Fox Island Directory that includes mailing addresses, phone numbers and EMail addresses for members. If you would prefer not to have some of your information included in the directory, please indicate your preferences below.

Do NOT publish my:

Please note that if you choose to not provide any contact information (address, phone, email) you will not be listed in the Fox Island Directory.

ADDITIONAL INFORMATION (Optional)

Additional Information

Enter any additional information you would like to provide with your Membership Application/Renewal.

ANNUAL DUES

Fee 1 Title

Annual Dues *

FICRA BUILDING TRUST DONATIONS

Fee 2 Title

Trust Donation

Fee 3 Title

Citizens Patrol Donation

Fee 4 Title

Emergency Planning Donation

TOTAL DUES/DONATIONS

We use PayPal to process payments, but you do not need to have a PayPal Account to make a payment. Just click the "Pay with Debit or Credit Card" link when you see their screen to enter your information without signing up for an account.

Dues Subtotal

Donations Subtotal

Total Due