Individual/Club Supporter (Circle One)
Name___________________________________________________________
Address _________________________________________________________
City_______________________________State____ 9 Digit Zip_____________
Phone__________________________Email ____________________________
Name of Club (if any) ________________________________________________
Individual Supporter Dues
1 year supporter - $20.00
3-year supporter - $50.00
Club Supporter Dues
$100.00 per year, less than 50 members
$2.00 per year per member, over 50 members
Make checks payable to VHDOA
Mail to:
Bob Kane
P.O. Box 111
Madison, Virginia 22727
Note: All supporters receive VHDOA's email alerts.
Club level supporters may nominate a representative to VHDOA's Leadership Group.