FCTA MEMBERSHIP RENEWAL FORM

Click on the boxes and type information in the blanks and then print the completed form, or print blank form from your browser and complete it, then send completed form with your check to

 

 

Fairfax County Taxpayers Alliance
P.O. Box 356
Fairfax, VA 22030

 

I have been a member of FCTA, and I want to stay in the battle to control Fairfax County taxes, spending and performance:

__Please update my membership in the Taxpayers Alliance.

__ Enclosed is my annual membership contribution of $15.

__ I am enclosing a donation of $  to help the Taxpayers Alliance cover the expense of Newsletters, Web Site, FCTA's Lobbyist, newspaper ads, handouts and mailings.

Name:

Street/PO Box:

City/State/Zip

phone:
e-mail:

I decided to renew because of

FCTA newsletter personal contact FCTA Web site an FCTA mailing FCTA Handout newspaper story speech or presentation government actions
other:

 

  NOTE: This information is used for FCTA purposes only. This information will not be shared by FCTA with any other organization or individual not working for FCTA except at your request.

DUES AND GIFTS ARE NOT TAX DEDUCTIBLE
because the FCTA tries to influence Tax legislation.

 

Web Rev: November 4, 2001