CJVG
INFORMATION FORM
Name
_______________________________________________________________________ Date __________________
Address
__________________________________________________________________ Telephone ______________
City ___________________________________________ State ____
Zip ________ E-mail
_____________________
Membership
Level: ___ Individual $10 ___ Senior Citizen (55+) $5 ___ Family $15 ___ Family - Senior Citizen (55+) $10
Membership
Type: ___ Renewal ___ New, referred by:
______________________________________________________
Would
you be willing to help with an activity?
___ Yes, call me when you need help and I'll help when I can!
How
did you hear about the group? __ Newsletter __ Social Function __ Advertising __ CJVG Member: _______________
Please make checks payable to
Central Jersey Vegetarian Group and return information form to Fully
paid membership dues are required to remain on the mailing list.
CJVG, PO Box 952, Manville NJ 08835.
For additional information, call CJVG at 908-281-6388.