Goochland Virginia Chapter Membership Form

Goochland VA & Vicinity Chapter Calendar Year will be from August to July.
Registration Renewal fees are due September 30th
Late fees are applied after December.
Your annual dues MUST be paid in full to participate in the National Convention.

Form Type:   First Name: Last Name: Address: City: State: Zip: Home Phone: Cell Phone: Work Phone: Email: Church: Instrument: Date of Birth: Voice Part: Read Music: Yes No If you paid for more than one person (youth - senior). Please list all names below. Please note: Names listed will be checked against amount paid ANNUAL REGISTRATION FEE Registration Category   Regular     Late - After Dec. Children_____ (5-11) Free Free Youth_______ (12-20)   $20  $25 Regular______ (21-61) $40 $50 Senior_______ (62-up) $20 $30 Associate_____ $60 $65                                                              This test prevents automated submissions Enter the text that appears in above image: