New Membership Application

    Once you complete and submit this form, send a check for dues (Box 2, below) payable to
    DC|CHC to: DC|CHC, c/o Blake Jones, 39 U Street NE #1, Washington, DC 20002

    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