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Funeral Consumers Alliance of Vermont

Membership, Donation and Volunteer Application Form

We welcome all to membership in the Funeral Consumers Alliance of Vermont. Lifetime memberships are $20 for an individual, $25 for a couple, and $10 for additional family members. And we very much appreciate annual donations to support our ongoing work!Please print this page and write your information in the form below.

Name :: ____________________________     Telephone :: __________________

Address :: ________________________________________________________

Email :: ______________________________

____ I’M/WE’RE NEW! I’m enclosing $_____ for membership for an individual __ or  for a couple and ___ membership and for additional family members.

____ YES!  I’m renewing my support for the Funeral Consumer’s Alliance of Vermont and its mission of promoting and protecting a consumer’s right to choose meaningful, dignified,  and affordable final arrangements: funeral or memorial services, care of the body and disposition of human remains (including burial, cremation, or donation). I’m enclosing my voluntary contribution of  ::

$15 Student___   $30 Adult___   $60 Supporter___   $120 Benefactor___  

Other Amount $_______

____ I have time and interest in helping Funeral Consumers Alliance of Vermont. Please contact me about volunteer opportunities.

Please make checks payable to FCA-VT and send with completed form to Funeral Consumers Alliance of Vermont, PO Box 144, Plainfield, VT 05667-0144.

Or e-mail us.

For immediate and personalized information or answers to other questions not addressed here, please call 802-223-8140 or 802-454-1131.

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