Name:______________________________________________________
Address:____________________________________________________
City, State Zipcode:___________________________________________
Phone:_________________________________ Phone Type: Home ___ Work ___ Cell ___
Email:______________________________________________________
Please check one: New Member _____ Renewal _____
Comments:_________________________________________________
How did you hear about the FVEAA ? _______________________________
Membership Types and Annual Dues
The FVEAA offers these types of memberships (please circle your choice):
| Youth (21 or younger) | $ 10 |
| Individual | $ 20 (1 year) |
| Individual | $ 38 (2 years) |
| Individual | $ 56 (3 years) |
| Business | $ 100 |
| Premier Business | $ 250 |
| Charter Business | $ 500 |
Newsletter Delivery Types (please circle your choice):
| No Newsletter | |
| Electronic | |
Please make your check payable to "FVEAA" and postal mail it
with this membership application form to:
FVEAA
PO Box 214
Wheaton, IL 60187-0214
Attn: Membership