VSSLC ANNUAL MEMBERSHIP FORM

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This form will be used to ensure that we have an accurate account of our membership and dues

Name of member *

Division/District/Organization *

Job Title *

# of years in position *

Brand new

1-5 years

6-10 years

10 or more

Retired

Email to be used in the VSSLC Google Group (Listserv) *

Professional email (if different from above) *

Membership Amount (and or meeting/session fees) *

One year membership ($20)

Two year membership ($40)

Fall Meeting ($50)

Spring Meeting ($50)

One year membership ($20) + 1 Meeting ($50)

One year membership ($20) + Both Meetings ($100)

Submit

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