155 River Woods Boulevard, Melbourne Beach, FL  32951
Phone:  321-729-6223     Fax:  321984-1458

Pest Control Form 


Name               ____________________________________   Date            _____________
 Street Address  ___________________________________ Unit Number  ______________  
Phone Number  ____________________________________


 I wish to enroll in the 2007 optional Pest Control Program.

____Owner            ____Renter (Needs owner's permission)


 Please select one of the following options:

         ____I wish to pay a year in advance ($96) with my prepaid Maintenance Fee
         ____I will pay monthly (Add $8 to Maintenance Fee)


Homes are sprayed once a month.  Homeowner must provide permission for the pest control service person to access the unit for spraying purposes and also, supply a key to the Beach Woods Office.  Renters need owner's permission to participate in this program. Service may be cancelled if fees are not paid promptly.

Key Provided: Yes ____No ____

Enter any special instructions:



Please print this form, fill it out and either deliver it, fax it or mail it to the office.

Please print a copy of this form for your records.

    For Office Use Only:   Input Date__________        Input by:________