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Membership Form

CJVG INFORMATION FORM - No longer required (there are no dues)


Name _______________________________________________________________________  Date __________________

 

Address __________________________________________________________________      Telephone ______________

 

City  ___________________________________________   State ____  Zip  ________     E-mail  _____________________

 

Membership Level: ___ Individual  $10    ___ Senior Citizen (55+) $5    ___ Family $15    ___ Family - Senior Citizen (55+) $10

                                     

Membership Type:  ___ Renewal    ___ New, referred by: ______________________________________________________

 

Would you be willing to help with an activity?   ___ Yes, call me when you need help and I'll help when I can!

 

How did you hear about the group?  __ Newsletter   __ Social Function  __ Advertising  __ CJVG Member: _______________

 


 For additional information, call CJVG at 908-281-6388.

 
 

 

 

 

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