Membership

To join, please fill in the following information. Dues are $15 for individual or $20 for family.

Name/s________________________________________________

Address________________________________________________

E-mail Address(s)________________________________________

Preferred Phone # ____________________Home_____Mobile______

New Member?_______ Renewal?_______

Payment Method: Check _______Cash______

Amount Paid: $15 _______ $20_______

Make your check payable to the NRVBC and mail to:

NRVBC

c/o Jana Ruble

P.O. Box 361

Blacksburg, VA 24063