HVAG Membership Application

Print out the application and send to

HVAG, PO Box 2196, Poughkeepsie, NY 12601

Date: _____________________

Artisian’s Name: ______________________________________

Partners Name: ______________________________________

Address: _______________________________________

City: ________________________________________ State: ____ Zip: ________

Phone: __________________________________

Email: ___________________________________

Website: _________________________________

Type of Work: ____________________________

Check amount $30 ____ (individual) ……. $40 ____ (Partnership) (both members vote & have benefits, receive 1 newsletter

Referred by: ____________________________________

10% discount to other Guild Members….. Yes ____……………… No ____

Electronic Newsletter : Yes ____……………… No ____

Make check payable to HVAG with “membership” in memo section of check