SOCIETY OF VIRGINIA 2010 DUES

Dues Are Due

Dues for 2010 are past due.  A form for submitting the dues is below.  Please remit the dues to Gail Sullivan, 5010 Devin Green Lane, Fairfax, VA 22030.

PRINT FIRST & LAST NAME

___________________________________________________________________

ADDRESS

Street________________________________________Apartment__________

City_____________________________State _____Zip Code____________    

TELEPHONE  _______________________________

E-MAIL _________________________________________________________

DUES ENCLOSED 

$ _____________  Family Membership ($25.00)

$ _____________  Single Membership ($15.00)

MAIL TO:   The Society of Virginia Membership Director

                     c/o Gail Sullivan

                     5010 Devin Green Lane

 Fairfax, VA 22030