Membership Information

Please fill out the form below and be sure to send your membership dues to the address shown at the bottom of the page. For NEW memberships, payment is expected within 10 days of submission. For renewals, please be sure to send your payment prior to your membership expiration date (see mailing label for date.)

Membership Types: (please enter in Membership Type Request field in form)

Individual - 1 year - $15

Individual - 2 year - $25

Family - 1 year - $20

Family - 2 year - $35

Corporate - 1 year - $35

Contact information:

First and Last Name:

Mailing Address:

City, State and Zip:

Email Address:

Phone Number:

Request information on:

Membership Type Request:

Best way to contact you:

Upon submitting your membership request, please send your dues within 10 days of application to:

Barb Kotzin, VSA Membership Chairman
bkotzin1@verizon.net

An acknowledgment email will be sent to you confirming your membership request.