MEMBERSHIP APPLICATION
Please include me as a
member of the Crime Victims Action Alliance
I have enclosed my annual membership fee
of
$40 individual membership ____ $ 350 individual life time membership
_____ $60 family (same household) ____ $ 550 family life time
membership
_____ $20 student membership ____ $35 distinguished membership (65+
years)
_____ $200 Corporate/Organization membership
Date of Birth _____/_____/_____ (required for student and distinguished
memberships)
Contributory Life
Membership
____ $1200
Sustaining Member
____ $3500 Sponsor Member
____ $5000 Patron Member
As a Sustaining, Sponsor
or Patron member, you will receive special recognition at CVAA events,
recognition in the bi-annual newsletter, a certificate suitable for framing,
and a membership card.
Please make checks payable to the
"Crime Victims Action Alliance".
Contributions, gifts or
membership dues made to the Crime Victims Action Alliance are not
deductible as charitable contributions for federal income tax purposes.
Name or Organization
Contact person
______________________________________________________
Address
City
State
Zip
Phone (home)
(business) (fax)
Email Address
___________________________________________________
I, or my organization,
can help the Bureau by:
Writing letters to legislators when requested.
Contacting my local media when requested.
Recruiting individuals/organizations to join CVAA.
Testifying before the legislative committees at the State Capitol.
Signature
_______________________________ Date______________________
The CVAA reserves the right to refuse
any membership request. Please
send the completed application with your check to Crime Victims Action
Alliance 1809 S Street, Suite 101316, Sacramento, CA 95811
