PVCA Membership Application Annual dues for membership are: $10.00 for active (public/non-profit organization) members, $400.00 for sustaining associate members, $5.00 for student members. Membership dues for the following year are included in the registration fee for the annual statewide training conference (held each Fall). You do not have to be a current member to attend the conference. Members receive a printed newsletter during the year and also have access to the email discussion forum. If you would like to apply for membership prior to the conference, please complete the following information and mail this form along with a check to the address below. NAME:___________________________________________ ADDRESS Line 1:__________________________________ ADDRESS Line 2:__________________________________ ADDRESS Line 3:__________________________________ PHONE NO._______________________________________ EMAIL:___________________________________________ Membership Options: _____ Active (Public Agency/Non profit) $10.00/year _____ Sustaining Associate $400.00/year _____ Associate (Student) $5.00 Please make check payable to: PA Vector Control Association and mail this form and payment to: Ms. Carmen L. Reichard c/o Mercer County Rodent Control Program 2491 Highland Road Hermitage, PA 16148