Why Join SCVAN?

Crime and fear of crime are taking a terrible toll on South Carolina. Each of our citizens can alleviate this situation by taking any number of steps.

AS A MEMBER OF SCVAN, you can:

First Name: Last Name:

Shirt size: _____Men's ....._____Women's.... ___S ....___M ....___L ....___XL

Street Address:

City: State: Zip:

Home Phone: Home Fax:

E-mail:

Organization Name:
*Public Agency membership includes 4 persons - $15 for each additional person
List names for public agency membership:
______________________________________ Shirt size: ___Men's ___ Women's __S __M __L __XL
______________________________________ Shirt size: ___Men's ___ Women's __S __M __L __XL
______________________________________ Shirt size: ___Men's ___ Women's __S __M __L __XL
______________________________________ Shirt size: ___Men's ___ Women's __S __M __L __XL
Additional Names:
______________________________________ Shirt size: ___Men's ___ Women's __S __M __L __XL
______________________________________ Shirt size: ___Men's ___ Women's __S __M __L __XL
______________________________________ Shirt size: ___Men's ___ Women's __S __M __L __XL
______________________________________ Shirt size: ___Men's ___ Women's __S __M __L __XL

Street Address:

City: State: Zip:

Phone: Fax:

If a victim/survivor: What was the nature of the crime? (in general terms)

I would be willing to do the following volunteer service for SCVAN :

  Clerical   Mailings   Victim Rights Week
  Library Cataloging   Clipping news articles   Other

If you are a First Year Victim:
Otherwise

Please print this form and send with your membership dues to:
SCVAN, 1900 Broad River Road, Columbia, SC 29210