2008-2009 CVQG MEMBERSHIP |
| Date: __________________ |
| Name: _______________________________________________________ |
| Address: _______________________________________________________ |
| _______________________________________________________ |
| ___Address Change/Correction? |
| Phone Number: ________________________ |
| E-mail Address: _________________________ ___E-mail Change/Correction? |
| ___New Member ___Renewing |
| Membership ($20) fee paid by ___Cash ___Check made out to "CVQG of Vermont" |
| Tax-deductible contribution to CVQG ______. |
| Hand this form and payment to the Membership Chair (Phyllis Billings or Priscilla Roehm), at a meeting, or mail to them at: 222 Main Street, Colchester, VT 05446 |
| Questions? E-mail or call us at chickyperry@comcast.net 802-878-8606. |
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