Membership Form


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Minutes 

Professional Awards

Membership Meetings

  for 2008

Jan 16 (Snow Jan 30)

April 15  July 16

October 15

Interested in joining NHAVA?

Print out this application, fill it out and mail it to:

NHAVA/Membership Committee

PO Box 3364

Concord, NH 03302 - 3364

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Office Use Only:             

Enrollment Date__________ pd Check#____________Amount_________

I am willing to serve on the following committees:

Communication_________ Legislative_________ Membership________ Newsletter_________ Program_________ Hospitality_________ Special Projects_________

Please include your membership fee when returning this form.  Make check payable to NHAVA for $35.00.  Complete all information below and please PRINT or TYPE.

Name____________________________Title________________________

Organization Name_____________________________________________

SUPERVISOR'S NAME and TITLE   _______________________________

CEO NAME and TITLE  _________________________________________ 

Address (Home)_______________________________________________

City/Town _____________________ZIP Code _________ 

Address (Work) ___________________________________

City/Town _____________________   Zip Code ________

Work #_____________________  FAX #     ________________________

E-Mail _____________________________________________

The membership has voted to give the NHAVA Board the authority to determine when to share the NHAVA Mailing List.  Check here if you do not want your name included on the mailing list __________