Membership Application

Thank you for your interest in Capital Region Vegan Network!

Please note that membership runs January 1st through December 31st.

Please fill out the following fields.  Fields with an asterisk (*) are mandatory.  Your information will be used for administrative purposes only.

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We are excited to have you join our community.  See you soon!

If you would like to manage your NeonCRM account (i.e., view donation history, renew membership, etc.), please create a login name and password below. Your password must be at least eight characters long, and contain at least one number.
NeonCRM by Neon One

You are donating to : Greennature Foundation

How much would you like to donate?
$10 $20 $30
Would you like to make regular donations? I would like to make donation(s)
How many times would you like this to recur? (including this payment) *
Name *
Last Name *
Email *
Phone
Address
Additional Note
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