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Click here to printout out the WVRPA Membership Application Form


ONLINE WVRPA MEMBERSHIP APPLICATION

INSTRUCTIONS:
Use the form below to submit your membership information. Following submission of the form please submit payment by postal mail.

Questions? Contact:
Bruce Miller
(304) 669-3181
wvrpaorg@gmail.com

Name
Title
Agency / School / Business
Street Address
City
State
Zip
Work Phone
Cell Phone
Fax
Email

WVRPA Membership (check one)               

New                
Renewal
Membership Categories

Active  $35/year                                
Board/Commission $50/year
Student $10/year                                
Affiliate/Business  $75/year
Agency $250/year

Specific Area of Professional Interest

Aquatics      
Community Recreation       
Commission/Board Member                                     
Commercial Recreation 
Federal/State Government
Park Maintenance                                   
Senior Citizen 
Supplier of Leisure Products
Therapeutic Recreation
Voluntary Agency (i.e. 4-H)
Professional Education                                              
other

 


 

 

 

 

 

 

 

 

 

 

 



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