Membership Application

Your Name(s):


Your Address:


Phone:
E-mail: 		....
Dues
Individual $12
Family $20
Student $7
Sustaining $30

Optional Contributions
Adopt a Bluebird $15
Add'l Contribution
How did you hear about the club?:



Please fill out and print this form and send it and your check made payable to the RVBC to:
Robin Austin, Treasurer
10513 Bottom Creek road
Bent Mountain, VA 24059-2311

When we receive your check, we will send you a copy of our latest newsletter. In it you will find information about upcoming field trips and meetings. We look forward to having you as a member.

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