Membership Registration

Welcome to the
Napa Valley Men's Network

You may either print the form below and complete the requested information by hand or send this form by clicking "submit" and mail your membership payment separately. NOTE: The name on on your check must match the member name below.

Be sure to check the appropriate box(es). After printing, please send a check, made payable to "Napa Valley Men's Network", for $20.00 for twelve months. Your named partner is included with your membership.

Please mail your check (and a copy of this form if you do not submit it on line) to:

     Napa Valley Men's Network
     Post Office Box 216
     Vineburg, California 95487

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I wish to join or renew membership in the Napa Valley Men's Network.

Please put my name on the "Open" list. I understand that by checking this box my information shall only be given to other NVMN members who are also on the "Open" list. I understand that if I leave this box empty I will be removed from the "Open" list, and my name shall not be distributed to anyone, including members of the NVMN.

I would like to host a NVMN event.

I am unable to host an event, but would like to co-host an event.

I would like to participate by working on the web site.

I would like become a newsletter editor.

My name:

My parner's name: (if applicable)

Mailing address #1:
Mailing address #2: (eg., Apt. Number, etc.)

City: State: Zip Code:

Phone Number #1: (optional)

Phone Number #2: (optional)

Email address: (optional)

Thank you for joining us!

Please feel free to make any suggestions about ways to improve our organization. Your suggestions are certainly appreciated and will be given serious consideration. If there is any other information or concern that you would like to share with us, please use the suggestion form link above, or if you print and mail this form, write your comments on the back.

Thank you!