WCCB Membership

Name _______________________________________________________

Spouse__________________________________________________

Address_________________________________________________

City _______________________ State_______ Zip _______

Summer Address________________________________________________

City _________________________________ State___________Zip___________

Summer address valid from (Dates)
_______________________________ to ________________________________

Email_________________________________________________

Home Phone______________________________________________

Member of Wine Country Only:  Send $25 payable to WCCB and mail to:

WCCB, C/O Judy Withers 83 Sylvan Road, Rochester, NY  14618

I wish to join ACBS also ____________

ACBS dues are $55. Please send $80 (which includes WCCB’s dues of $25) if you wish to join both organizations. Please make check payable to ACBS, Inc. and send to:

ACBS, 422 James Street, Clayton, NY  13624

Please remember to send  address, telephone or email changes during the year as well.