Membership Form

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Please print this page and mail it in to confirm your membership. Thank you! 

Spiral Grove Membership Form for 2010

 

Please enroll me as a Spiral Grove Member at this level: (check one please)

 

     Class I Community Membership ($15 per year)

     Class II Leadership Adult Membership (Age 18 +, $80 per year)

     Class II Leadership Teen Membership (Ages 13-17)

 

(please print clearly)

 

Name _____________________________________________________

Address____________________________________________________

City_____________________________________________State_______

Zip____________

Home Phone _____________________

Alternate Phone___________________

Fax # __________________________________

Email Address______________________________________________

 

PAYMENT OPTIONS (Thank You!)

 

Option 1

I would like to pay my entire membership. I am enclosing a check for $__________,

 

Option 2

I would like to pay my membership in installments of $_________ /month for one year, for a total of $__________.

 

Option 3

I am choosing to work 8 community service hours in 2008 instead of remitting the $80 dues to cover for my Class II Leadership Membership.

 

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SIGNATURE AND COMMITMENT  

 

I understand that signing below signifies that I have read and understand the information set forth here. I understand that all information I have given here will be kept confidential by the Spiral Grove and will not be given out or distributed.

 

I understand that if I chose Option 3 that I am committing to working 8 community service hours within the year of membership and that my written commitment of work must be submitted to the Spiral Grove Membership Committee for review. I understand that I am to contact the Spiral Grove Membership Committee for further information and any questions I may have about Option 3.

 

 

Signature________________________________________________

Printed Signature ____________________________________________                                                                                Date_______________________________

MAIL TO:
 
The Spiral Grove
Membership Drive
P.O. Box 24
Stephens City, VA 22655
Thank you for your continued support of The Spiral Grove, your membership is very important to us and we appreciate your contributions!
 
REMEMBER...We are a 501c3 non-profit and your loving and generous donations are tax deductible.

Copyright 2010. The Spiral Grove.