Membership Application Form
Name(s)
__________________________________
__________________________________
Mailing Address
__________________________________
__________________________________
__________________________________
E-mail Address
__________________________________
Membership Levels
Household Membership ($50) __________
Individual Membership ($35) ___________
Tax deductible donation of $ ___________
(All memberships are tax deductible.)
I would like to become involved in the
following:
___ Programs for children
___ Summer concerts
___ Poetry and writing
___ Drawing and painting workshops
___ Piano competition
___ Housing piano contestants
___ Culinary Classes
___ 2011 Quilt Show
Complete and mail the form to:
CVAC
P.O. Box 848
Cape Vincent, NY 13618
A 501 (C) (3) Corporation
Federal ID #16-1529556