Membership and Reservation Form

PRINT THIS FORM AND USPS MAIL TO:    

GVR MICHIGAN CLUB MEMBERSHIP / RESERVATIONS,   PO. Box 232,     Green Valley, AZ 85614

PLEASE ACCEPT MY CHECK FOR THE FOLLOWING:

Name(s) ________________________|______________________________

Are you a member of GVR?: NUMBERS(s) _______________ |______________

Michigan Address  _____________________City___________________State_________ZIP_____________

Green Valley Address_____________________City___________________State_________ZIP_____________

Phone Number: Land Line _________________ Mobile _____________________

Email Address ________________@___________________

Annual Dues $10 per Person  ________

COMPLETE THE FOLLOWING IF YOU ALSO WISH TO MAKE EVENT RESERVATIONS

Dinner Reservations Per Person:    (All reservations add $3 for non-members or guests)

December            $23.00            $____________

January                $12.00            $_____________

February              $23.00            $_____________ 

March                    $23.00            $_____________ 

April                      $23.00            $_____________

GRAND TOTAL (including dues and dinners)               $_____________

Note: It is not necessary to pay for the entire year. Only pay for one month or any months you plan to attend, if you wish.

If you have questions, please call  Rita Papes at 810-985-7077 or email at rpapes@comcast.net

Office use only: Check No.: ____________ Amount: ____________