Grenada Cultural & Civic Association Membership Application Form "To Aspire, Build, Advance As One People, One Family" We need your skills, knowledge and experience. Together we can make a difference JOIN US! PLEASE READ!!   Membership registration is a 3 step process as follows: Step 1: Fill out and submit the form below by clicking the "Ready To Join" button. Step 2: After submitting this form you will then be taken to a second page that consists of two PayPal buttons. One labeled Pay Membership Fee and the other labeled Pay Annual Dues. Simply click on the appropriate button to be redirected to PayPal. Step 3: Securely make your payment using PayPal's Secure payment system. In an effort to minimize confusions and ensure that you are credited properly, we recommend that the information you enter below match the billing information you enter in PayPal, if possible. If the billing information that you will enter on PayPal does NOT match what you will enter below, please provide us with the Billing Name ONLY from the PayPal billing information in the box labeled "PayPal Billing Name" below. This will help us to speed up your registration process. Thank You! STEP 1   * Indicates required information
		* Full Name:    PayPal Billing Name (Optional): * Address: * City: * State: -- select -- AK AL AR AS AZ CA CO CT DC DE FL FM GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY   * Zip Code:   * Phone (Home):    Phone (Business):    Cell Phone:    Fax:    Email Address (If Applicable): * Occupation:     * I Am Paying My: Membership Fee ($25.00) Annual Dues ($20.00)     * I Am Interested In The:   Membership Committee   Fundraising Committee   Program Committee   None     * May we publish your information in GCCA's directory listing? Yes No