Name(s):___________________________________________________________________________________

Address: ___________________________________________________________________________________

Phone: __________________________________

E ­ Mail:__________________________________

Type of Class :_____________________________

Class Location: ____________________________

Class Session______________________________ (Class Session: e.g., Spring 2008, Fall 2008, etc)

Amount Paid:$___________ ($70 member, $110 non-member, 2 family members $60 each.3 or more family members $50 each.If two or more classes are taken, $60 per class for members.)

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Please check the appropriate membership type for the current year. (Note: If you are already a member of CCE-DV for the current year, please disregard. All memberships are due for renewal in the fall.)
__ $25.00 • First Senior Membership. (Includes TREOIR magazine subscription)
__ $8.00 • Other Adult members in the same family or household.
__ $4.00 • Junior members under 18 years of age.
__ $16.00 • Junior members under 18 years of age. (Includes TREOIR magazine subscription)
__ $35.00 • Family Membership (Includes TREOIR magazine subscription) If applying for Family Membership, please list both adult and children's names:

 

 

Please make checks payable to CCE-DV. Please bring completed form and payment to first class.