Membership--Mail form

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 2010 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 ________ Student Associate $10 ________ (Students Associates receive the email PCAS Newsletter [no Quarterly] and have no voting rights. Please submit proof of student status.) 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 $ _________

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

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  ________

Student Associate             $10  ________        (Students Associates receive 
                                                    the email PCAS Newsletter 
                                                    [no Quarterly] and have no 
                                                    voting rights. Please submit
                                                    proof of student status.)
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 $ _________