California Garden Clubs

Dues: Additional Members (Clubs/APS)

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This form is to report additional members who join after you have sent your original payment for the 2016-17 club year. Valid through June 30, 2017

Example: Members who join or rejoin in late summer, September or throughout the year

Checks payable to CGCI; mail to Rita Desilets, 8316 Sparton Avenue, Van Nuys 91402-4030

Please submit your FINAL payment by June 15, 2017

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Organization Name *

District (if applicable)

Number of additional members (include honorary/life members) *

Amount enclosed (Number members x $2.75) * $

NOTE: The dues increased to $2.75 per member effective July 1, 2016.

Check Number *

Check Date (mm/dd/yyyy) *

Your name (person submitting form) *

Your email or phone number *

Print TWO copies before clicking the Submit button below

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Dues: Additional Members (Clubs/APS)