MVBA Membership Form
(see
MVBA Privacy Policy
)
Membership Type:
M1-Individual - $20
M2-DualFamily - $30
M3-Senior - $15
M4-Senior Dual - $20
M5-Student - $10
M6-Sustaining - $30
M7-Business - $50
M7a-Business 2yr - $100
M8-Institution - $350
M9-Benefactor - $350
L1-Individual Lifetime $350 (see note)
L2-Family Lifetime $500 (see note)
L3-Business Lifetime $500 (see note)
C1-Contribution $Any (see note)
First Name*:
Middle Initial:
Last Name*:
Institution/Business Name:
Students - Enter your student ID# here
Address Line 1*:
Address Line 2:
City*:
State*:
Zip*:
Phone:
eMail:
Name2:
Use for Family/Dual Membership
eMail2:
Use for Family/Dual Membership
Newsletter:
Check if you wish to receive our newsletter by email (you'll get it up to a week earlier, save the association printing and distribution fees, and perhaps save a tree or two).
Committee:
Are you interested in joining a committee?
Interests:
Indicate your community interests/concerns.
PAY ONLINE :
(This may take a moment - click only once please.
)
PAY BY CHECK:
Print this form and send your check to:
NOTE:
Lifetime membership and donations are deductible with check to:
Mt. Vernon-Belvedere Association John Eager Howard Society
1221 N. Calvert Street c/o Mt. Vernon-Belvedere Association
Baltimore, MD 21202 1221 N. Calvert Street
Baltimore, MD 21202
* = Required Field
MVBA Privacy Policy