Membership and Donation Form

Mail to:

Southeastern Virginia

GOLDEN RETRIEVER RESCUE, EDUCATION, AND TRAINING

P.O. Box 8014, Yorktown, VA 23693  (757)827-8561

Please fill in the following:

 Last Name:     First Name:

Street Address:

City:   State:   Zip Code:

Home Phone: Work Phone:

E-Mail Address:


Note: Membership is open to all persons 18 years or older.

Please check all that apply:

I am enclosing $25 for my 2008 membership dues (this includes voting privileges plus the quarterly newsletter).

This is a new membership.

I am enclosing a tax-deductible donation as listed below..

I would like to volunteer please contact me.

Please remove me from the mailing list.

                        TOTAL REMITTANCE TO BE SENT:

                                              $ Dues

                                              $ Donation

                                              $ Total

What are your suggestions for activities for GRREAT (specific fund raisers, publicity activities, etc.):

How did you here about GREAT?

 

                                                         

 

Please print this form for mailing with your remittance,

before pressing the submit button.

   

Return to the SEVA GRREAT Home Page


Send e-mail to webmaster@sevagrreat.com with questions or comments about this web site.  
Copyright ©MM Southeastern Virginia Golden Retrievers Rescue, Education, and Training, Inc