Autumn Valley Golden Retriever Club

2014 Membership Dues Renewal

 

Type of membership:  _____Individual   _____Family

Name(s):______________________________________________________

 

Address: ______________________________________________________

 

               ______________________________________________________

 

Phone#    ______________________home

 

                ______________________ cell 

 

E-Mail:__________________________________________

 

Kennel Name:_____________________________________

 

Please complete above information, even if no changes, and return with your check or money order payable to AVGRC.

Return to:    

Dave Overbeck, Treasurer

AVGRC

P.O. Box 779

Vestal , NY 13850

 

Amount Enclosed:

 

Individual $25  _____

 

Family       $30 _____