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HVLSA 2020-2021 Membership Form
Please complete this form for your membership and forward the payment to HVLSA, PO BOX 54, New City, NY 10956
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Last name
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Your answer
First Name
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Your answer
Title
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Your answer
Agency
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Your answer
Email Address
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Your answer
Cell Phone
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Your answer
Work Phone
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Your answer
Home Street Address
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Your answer
Home Town
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Your answer
Home State
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Your answer
Home Zip
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Your answer
Year you became a Full Time Recreation Professional:
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Your answer
Professional Endorsements/certifications:
Your answer
Membership you are purchasing
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$95 Deluxe Membership
$40 Commission Board Membership
$25 Associate Membership
$15 Student Membership
Indicate how you will make payment
*
Mailing a check to HVLSA, PO BOX 54, New City, NY 10956
Bringing payment to the next meeting
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