Dues: Additional Members (Clubs/APS)

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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Due Periodically

PLEASE NOTE CHANGE OF

ADDRESS FOR PAYMENTS

For members joining after the

initial payment for the 2017-18 year.

1. Complete the form

2. PRINT THE PAGE (click "Print Form" button. Print TWO copies - one to mail and one for your records)

3. SUBMIT AN ELECTRONIC COPY of the form (click "Submit" button)

4. Make Check payable to "CGCI" (Dues are $2.75 per capita)

5. Mail printed form and check to:

CGCI Membership Admin Asst:

Rita Desilets

8316 Sparton Avenue

Van Nuys, CA 91402-4030

Related Items

Contact Information Form (Clubs/APS)

NOTE: If no initial payment is received by October 1 the organization becomes ineligible for participation in the CGCI Awards program and to apply for Liability Insurance or the Group Tax Exemption Program.

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Dues: Additional Members (Clubs/APS)