Last updated: September, 2008
PLEASE PRINT CLEARLY
_________________________________________ Date of Birth: mo___/day___
Partner’s name: _________________________________________ Date of Birth: mo___/day___
Mailing Address: ________________________________________________________________
City: _________________________________________ State: _________ Zip: ________-_____
Phone Numbers: Home __________________________ Others __________________________
Email: _______________________________________ Anniversary: mo___/day___/year_____
List your hobbies, interests, specialties:
Signature #1 ___________________________
Signature #2 ___________________________
Membership dues are $45.00 per couple for the first year; $40.00 each year thereafter.
New memberships/renewals will run for one full year from the month the couple joins or renews.
Two photo badges are included in your 1st year membership dues. Badge pictures are taken at CVC events.
Please make check payable to Coachella Valley Couples sending it along with this application to:
CVC, P.O. Box 4104, Palm Springs, CA 92263-4104
If you require assistance with paying the annual dues, please include an explanation with your application.
COACHELLA VALLEY COUPLES
A Social Organization for Committed Gay and Lesbian Couples
Contact Sam and Tedd, Member Services Couple
Please check one:
CVC in no manner subscribes to nor supports any discrimination except that individuals under the age of 18 shall not be eligible for general
membership. By joining CVC, I release and discharge CVC and the officers from all claims in any manner arising out of property damage and
personal injuries sustained by me as a result of participating in any club activity. I waive the