RVA ANNUAL DUES STATEMENT

$15.00 PER YEAR

NAME_________________________________________________________________

ADDRESS______________________________________________________________

CITY______________________________________STATE____________

ZIP_______

PHONE_____________________________________EMAIL_____________________

YEAR -  2008______  ,2009_______,2010________

(Please check appropriate year)    

CHECK #_____________

Mail to:

Myron Crangle

3700 Westport Ave. PMB 2447

Sioux Falls, SD 57106