Membership and Subscriptions : Mail form

Please print this form, complete the requested information, and mail it with your payment to:

PCAS Membership
P O Box 10926
Costa Mesa, CA 92627

Memberships and subscriptions are for the 2008 calendar year. 


Name: ________________________________________________________

Street address: ______________________________________________

City: ________________________________________________________

State: _______________________________________________________

Zip: _________________________________________________________

Phone: _______________________________________________________

Email: _______________________________________________________

I have read and agree to abide by the PCAS Code of Ethics.

(signature) __________________________________________________

Membership

Please check one:

Active member              $45.00  ________        (All members receive the 
                                                    Newsletter and Quarterly)
Active family (2 persons)  $50.00  ________

Supporting member $55.00 or above  ________        (Supporting, Donor,
                                                    and Lifetime categories
Donor member         $75 or above  ________         may be individual or
                                                    family memberships)
Lifetime member            $1,000  ________


Subscriptions only

Quarterly only             $37.00  ________

Newsletter only            $18.00  ________

Both publications          $55.00  ________

__ Yes, I would like to receive the Newsletter by email ________________________
   Please be sure email address is legible.

__ I want to make an additional donation to scholarship fund of $ _________