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CPV Membership Application <br /> <br />'l"ne $500 annual fee covers membership from July 1 to June 30 or any portion thereof. <br /> <br />Organization Name CASS COUNTY GOVERNMENT <br /> <br />Address 211 9TH STREET SOUTH, PO BOX 2806 <br /> <br />City. FARGO <br /> <br />Contact Name ALON WIELAND <br /> <br />Telephone Number 701 241-5609 <br /> <br />Au~orized Name ~lease print). <br /> <br />Authorized Signature <br /> <br />State ND ZZPCode 58108 <br /> <br />ALON WIELAND <br /> <br />Fax Number 701 241-5728 <br /> <br /> <br />