DGC Membership Enrollment Form

Please complete and submit the Membership Enrollment Form to join as a new member or renew your existing membership. Please make sure that all information is complete and current.

Individual Membership dues are $20.00 per year. Family memberships are $30.00 per year. Annual membership renewals are due on or before March 31st each year.

Checks should be made payable to Depression Glass Club and mailed to:

C. Sue Holley, CDG Secretary/Treasurer

1234 Arlingwood Avenue

Jacksonville, FL 32211

You may also join as a new member or renew your membership dues at a regular monthly meeting. Visit our Calendar page for meeting dates.

Name*	Date of Birth* Month & day only mm/dd
Mailing Address*	E-Mail Address* An e-mail address is required A proper e-mail address is required
City* Please provide City	Home Phone* Please provide home or main phone
State	Cell Phone
Zip Code* Please provide zip code	Work Phone
Please list the first and last names & date of birth of other family members included in this paid membership:
Name	Date of Birth
Name	Date of Birth
Additional Comments
Please check the "Also send me a copy" checkbox if you wish to receive a copy of your membership enrollment form submission via e-mail.
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