Genesee Valley Woodcarvers Membership 

Annual dues:        $20.00 single or $25.00 per family
Checks payable to the Genesee Valley Woodcarvers

Name_________________________________________________

Date__________________________________________________ 

Address_______________________________________________ 

City__________________________________________________

State_________________________________________________

Zip___________________________________________________ 

HomePhone ___________________________________________

Work Phone____________________________________________ 

Email_________________________________________________   

Please complete the above form and mail it along with your check to:

                          Lucina Brogan
                          6796 Ann Lee Drive
                          North Rose, NY 14516