New Membership Application

    Return this form with a check for dues (Box 2, below) payable to DC|CHC to:
    DC|CHC, c/o Blake Jones, 1858 California Street NW #8, Washington, DC 20009

    1. COOPERATIVE

    YesNo

    2. DUES CALCULATION

    units

    x $1.50=

    (Please pay this amount. This is your co-op’s CHC dues.)

    3. CO-OP PRESIDENT

    4. DC|CHC REPRESENTATIVE

    5. CO-OP MANAGEMENT

    Self-managedContract-managed

    Co-op employeeManagement company employee