Membership Application - Coastal Virginia Photography Club

PLEASE FILL OUT FORM ONLINE BEFORE PRINTING

Date

First Name
Last Name

Street Adress

City State Select... AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip

Phone Email

Level of photography expertise

Do you have a photo sharing web site?

What camera brand and model do you use?

Check three (3) of your favorite photography interests below

     Action/Sports – Animals – Architecture – Birds – Flowers/Plants/Trees

     Insects - Macro – Night Photography – People/Portraits

     Scenic/Landscape – Low Light – Transportation

May we use your information in the Shutterbug Directory which is sent to MEMBERS ONLY?:
     Yes No

Please make check payable to Coastal Virginia Photography Club or CVPC.
    ($25 for individual; $45 for family living in the same household)

Bring your application and payment to the next meeting or mail to our Treasurer:

CVPC
c/o Nancy Morewitz
401 Bracey Way
Chesapeake, VA 23323
nmorewitz@verizon.net

For prorated dues for partial year, contact Mitch Rothschild (membership) mitchroth40@gmail.com before sending payment.

For other club information go to :
http://www.coastalvirginiaphotographyclub.com

Memberships are renewed in August.