CVGA Membership Form
All memberships start January 1 of each year.

Annual Dues:
$15.00--Individual/family/institutional membership--electronic newsletter
$30.00--Individual/family/institutional membership--print newsletter

(Don't forget to click the SUBMIT button at the bottom of this form, or all your hard work filling in this information will be for naught!)

After completing and submitting this form, go to the Paypal button below and pay dues, OR send a check to Treasurer, CVGA, P.O. Box 817, Earlysville, VA 22936-0817
Membership status *
Name(s) *
Street Address or P.O. Box Number *
City *
State *
Zip Code *
Phone Number *
Email *
User Name
The user name is the name you will use to log in to the CVGA website. You may use your current WordPress user name or another user name if you wish. If you do not choose a user name, the default will be the part of your email address before the @ symbol.
What surnames and counties do you have an interest in?
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