WPCUG Membership Application

Annual Membership Dues $50/family  
 

Check One:   New Membership                Renewal            

Name:
Address:
Address (cont.):
City:     ST:    ZIP:
Work Phone:     Home Phone:
Email:
Signature:

Mail the completed application with dues check (payable to WPCUG) to:
WPCUG
Earl Gundersen
36 Rochambeau Road
Garrison NY 10524