CPG Membership Form

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Thank you for your response. ✨

Name

Home / /Cell Number

Address

Spouse / Partner

Interest in Organization

Special Interest

Computers

Amateur Radio / ARES / ACS

Medical Training

First Aid CPR

CERT

Other information

CPG suggested voluntary membership dues $5 per year Jan-Dec

Membership Agreement

The undersigned agrees to be bound by the articles / bylaws and

applicable rules / guidelines of the Association

I agree to the Membership Agreement

Signature