Please fill out this form for renewals, new members and membership changes and send the form to the Treasurer:
Doug Della Pietra, M.Div., CPXP
Manager, Volunteer & Guest Services
Rochester General Hospital
1425 Portland Ave.
Rochester, NY 14621
*Plus online registration service fee
Once membership dues are received the member’s information on this form will be officially add/change/delete on our mailing list. The information will then be updated on our web page: www.nysavsa.org at which time active members will have full access to NYSAVSA and its services.
Any questions please contact:
Doug Della Pietra: