Become A Member

Please print this form and bring it with your check to the next dance, or mail it to the following address:

Green Valley Squares
P.O. Box 1472
Green Valley, AZ 58622-1472

$5 per person.                                                                                                                 Date:______________

Last Name:________________________________  First:__________________________  M.I.:__________

     Your GVR Number:____________________

Spouse/Companion:
Last Name:_______________________________  First:__________________________  M.I.:__________

      Spouse/Companion GVR Number:____________________

E-mail address:___________________________________________________________________________

GV Street Address__________________________________________________________________________

GV Home Phone (520) _________________________________

Your non-Green Valley address, phone number and e-mail address may be written on the back of this form if you care to do so.