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MEMBERSHIP INFORMATION
Membership is January through December. Dues are eighteen dollars for an individual and
twenty-four dollars for a family. Mail dues along with the completed information sheet below to:
CCAS
P.O. Box 5434
Walnut Creek, CA. 94596-1434 Thankyou! Name:
Address: City, State, Zip Code: Phone Number:
E-mail Address: Please indicate (with a yes or no) which of the following you would prefer:
I would like to be added to the roster with my name,address, and phone number:_______
Please include ONLY my name and phone number in the roster:_______
Please include only my name in the roster. No address or phone number:_______
I DO NOT want to be added to the roster:_______
I have enclosed a check/money order in the amount of:
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