New and Renewal Membership Application

Please Choose One *

I'm joining GVA for the first time

I'm renewing

I'm a former member rejoining GVA

Name *

Address *

City/State *

Zip *

Phone *

E-mail *

Check here if any of your contact information has changed since your last renewal

yes

Newsletter *

Membership Fee *

Individual Membership Dues: $40.00

Join after December: $30.00

Join after April: $60.00 (Covers balance of current year plus the following year.)

Family Plan: One full fee + 50% discount for each adult (18+). List family names below.

*Donation for the Bill Kubiak membership fund $

*Click here to learn more about the Bill Kubiak membership fund.
Direct membership questions to Mary Myszka at mysz312@comcast.net.

Total Amount * $

please add your membership fee(s) and any donation you would like to make, and enter it here