Ouachita River Valley Association (ORVA)

Membership Application

Enclosed is the sum of $ for an annual membership in support of the Ouachita River Valley Association. (ORVA). This membership becomes effective immediately and will remain in force so long as a member is in good standing and renews each year.

Name:

Contact person (organizations only):

Mailing Address:

City: 

State:

Zip:

Telephone Number:

Fax Number:

E-mail address:

Signature:

Date:

Annual Membership:

$50 per year Individual

$100 Small Business

$500 Corporate

$200 Civic/Professional

$200 Public Entity

$2,500 Sustaining Member

Contributing Members:

$250 Silver         $500 Gold         $1000+ Platinum

Please return completed form and cashier’s check, money order or personal check to:

Ouachita River Valley Association
PO Box 913
Camden, AR 71701