WPHCA Membership Application Form

Join or renew your WPHCA membership!

Our annual dues - plus voluntary contributions to the Scholarship Fund (financially assists deserving White Plains HS students from the Highlands), the Garden Fund (helps to maintain our two beautiful Highlands gardens), and the General Fund (supports the programs, activities, meetings, mailings, and much more that keep our community vibrant!). Payment can be made via PayPal, Venmo, or check. Note this form can also be used if you are renewing your membership.
Contact Information
Name – 1st Household Member

First NameLast Name
Name – 2nd Household Member

First NameLast Name
Email – 1st Household Member
example@example.com
Email – 2nd Household Member
example@example.com
Phone
Format: (000) 000-0000.
Phone 2
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState

Zip Code
Dues and Additional Donations
Annual association membership dues
We’ve kept dues low to ensure as many households as possible can participate. While dues help cover the administrative costs of running the association, they only partially fund our various activities and events. We rely on the generosity of our community through donations to one of our three funds to help close the gap. We hope you will also consider supporting one or more of our WPHCA funds below.
Scholarship Fund Donation (optional $ amount)
The Scholarship Fund enables the WPHCA to award an annual scholarship to a high-achieving graduating White Plains High School student from the Highlands who is pursuing additional educational opportunities.
Garden Fund Donation (optional $ amount)
The Garden Fund enables the WPHCA to maintain two neighborhood gardens that help beautify the Highlands throughout the year with varying flowers and plantings for each season.
Additional General Fund Donation (optional $ amount)
The General Fund provides additional financial support for the WPHCA to organize and promote neighborhood activities and events throughout the year.
Volunteering
I would like to volunteer for:
Billing and Payment
Payment Options
Total
If paying by check, please make your check payable to W.P. Highlands Civic Association, Inc. for the amount of money shown above, and mail to:

Charles Gagnon
Treasurer WPHCA
101 Smith Ave.
White Plains, NY 10605

Please indicate your street address in the memo section.
Should be Empty:

Join or renew your WPHCA membership!

Contact Information

Dues and Additional Donations

Volunteering

Billing and Payment