MEMBERSHIP
DUES RENEWAL FORM
(to accompany check - by Dec 31 before the new dues year)
| Name |
|
| Membership
category:
(circle ONE) |
| Individual |
$35./yr. |
| Family |
$45./yr. |
| Student (< 18) |
$10./yr |
| Corresponding |
1/2 price |
|
| If
there have been any changes in your address (home or e-mail ) or phone number since last payment, please enter in column to the right --> |
|
|
| Members who wish to make a donation (not tax-deductibe) in support of the educational activities of PACC may do so by entering the amount in the column on the right. An acknowledment will be sent. |
Amount of donation: $ ..................... |
|
TOTAL ---> $ ..................... |
