NVRHA Membership
And Relic Hunt Form

Please print this form, fill it out, and bring it to the next meeting, or mail, along with a check, to:

Northern Virginia Relic Hunters Association
c/o Karen Eubanks-Club Secretary
P.O. Box 5257
Falmouth, Va. 22403

Name:_____________________________________

Check one: New member [ ] Renewal [ ]

Note: If you are renewing, please indicate any address changes below.

Mailing address:

Street________________________________

City ________________________________

State ________________________________

Zip ____________

Email* _________________________________

* Your email address will be kept private. It will be used to send you the monthly newsletter, meeting reminder, etc. It may also be used by club officers to contact you concerning club matters only!

If you cannot attend the meetings and want your Membership card mailed
to you, check [ ]

Make checks payable to: NVRHA

Dues: Single person $30.00

Family (Immediate only) $35.00

If you wish to enter our 2011 Relic Hunt, the cost is $50 per member. If you are applying for an individual membership, enter your name and the $50 hunt fee. If you are applying for a Family Membership and others in your family wish to hunt, enter names of each including yourself and $50 for each member.

                                                  Dues      $_______



Your Name ______________________________________  Hunt Fee  $_______



Family Member #1________________________________  Hunt Fee  $_______



Family Member #2________________________________  Hunt Fee  $_______



Family Member #3________________________________  Hunt Fee  $_______



                                  Total Dues and Hunt fees  $______


Note: Membership must be paid or postmarked by 9/6/11 to qualify for our relic hunt.
Relic hunt fees will be $75 per person if paid after 9/6/11.

NVRHA MembershipAnd Relic Hunt Form

NVRHA Membership
And Relic Hunt Form