Mobile Home Park Owners-Developers Association 
 Wayne County, NC
 Kenny Fallin, President
updated 19 June 2017

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Mobile Home Park Owners - Developers Association

To join this Association, you may print this application and send it with your annual dues to: Attn: Pattie Daly 363 St. John Church Rd. Goldsboro, NC 27534.

Name of Applicant: ______________________________________________________

Full Mailing Address:_____________________________________________________

Phone Number: (Home)  ______________________     (Cell)  _____________________

E-mail Address: _______________________________________________________    

Are you a Mobile Home Park (MHP) Owner? _____   How many parks do you own?  _____

Are you a MHP Manager? _____     Number of parks managed?  _____

Name of Mobile Home Park(s) that you own or manage and their location: 
(Use back side of application if you need more space).
                       NAME​ & LOCATION                                                            SIZE
                                                                                                                (Example: 10 acres with 15 lots)
a.________________________________              ______________________________

b.________________________________              ______________________________

c.________________________________              ______________________________

Do you have someone else that operates/manages your park and will represent you on this Association?  If yes, please provide their name_________________________________

What do you hope to see achieved by this Association?___________________________


Does your park(s) have to operate under city or county rules or both?


Are you willing to be an ACTIVE member of this association? 
(i.e. attend meetings, work on committees, etc.)


Do you currently hold a position in the Association? If not, what committee would you like to work on? 


If you are not a park owner, what is your profession and affiliation with this Association? 


I agree to abide by the Association By-laws and to pay annual dues of $ _____

Applicants Signature: ___________________________________________________ 

                          Date: _____________________________________

This section is reserved for the Membership Committee & Association Officers. 

Based on By-Laws and information provided in the application what type member is the applicant?

1. Member:  ______ (park owner or manager)

2. Affiliate Member:  ______ (like business interests, etc.)

3. Public Service Members:  _______ (public utilities & services, etc.) (non-voting)

4. Honorary Member:  _______  (notable service, etc.) (non-voting)

Recommended to serve on the ___________________________________Committee.

Received Annual Dues of $ ____________   Date Received: _________________

Approved by Membership Committee: _________________  Approval Date: ________________ 

Membership Number: _________________________

Note: membership number will start with a 1,2,3, or 4 based on type of member shown above. After that, the second number will be 001, 002, etc.
Last revision of application form: 10/08/2013