GCA Supplier Membership Application

I, , do hereby make application for membership in the Georgia Cemetery Association (GCA) as a:

Contact Information

Cemetery or Business Name
Work Phone Fax
Website
Physical Address
City State Zip
Mailing Address (if different)
City State Zip
 
Primary Address: Please indicate ONE address in which to receive all GCA Mailings and Correspondence:
PHYSICAL Address is Primary Address
MAILING Address is Primary Address

Contact Information

First Name Last Name
Title
Email

All applications with payments will be reviewed by the GCA Board of Directors.


I certify that I have received, read, understood and hereby agree to abide by the Georgia Cemetery Association

Code of Ethics. I further assert that I have received, read, understood and hereby agree to abide by the Georgia
Cemetery Association By-Laws. I understand and acknowledge that failure to abide by either of the GCA Code of
Ethics or By-Laws will render my membership null and void. Both documents are available for review on our web
site: www.georgiacemeteries.org
Signature Date ?
   - denotes required fields

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