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Millennium Costumers Guild

Membership Form

Membership is $20 for Individuals ($16 Local, $4 National)

For Household Memberships, please add $4 National for each additional member at the same address.  Only one newsletter is sent to Household memberships.

Name

Address

Phone                                                                                                      Cell

Household members:

Email:

Interests:

Mail Form and Payment to:


Vandy Vandervort

2854 Tincup Circle

Boulder, CO  80305-7143

Amount Enclosed: ____________


Make Checks payable to:

Vandy Vandervort