CPG Membership Application

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Address

Home / Cell Number

Spouse / Partner

Interest in Organization

Special Interests

Special Skills

Computers

Amateur Radio/ARES/ACS

Medical Training

First Aid CPR

CERT

Other information

Signature

Date

CPG suggested voluntary membership dues $5 per year Jan-Dec
Membership Agreement
The undersigned agrees to be bound by the articles /bylaws and any applicable rules/guidelines of the Association.