California Classical Association

Northern Section

 

Membership Application Form

new / renewal (circle one)

 

Name_________________________________________________

 

Address_______________________________________________

 

City, State Zip__________________________________________

 

E-Mail (Important, as many announcements and even the newsletter will be in electronic format).________________________________________________

 

School Affiliation (if any)__________________________________

 

Choose Membership Category:

 

Regular ($15.00)                                                                   $_________

Student ($5.00)                                                                     $_________

Retired ($5.00)                                                                      $_________

CCA-South Affiliate Membership                                                 $_________

($5.00 You will receive the CCA-S newsletters as well)

 

Additional Contributions to:

 

Grant-In-Aid                                                                                 $_________

Laetaberis Journal                                                                         $_________

Marian McNamara Scholarship.                                                     $_________

 

Total Check Enclosed  (payable to “CCA-No.”)                            $_________

 

 

Please mail this form with payment to:

 

Michael Collins                                     

CCA-N Treasurer

30 Gloria Dr.

San Rafael, CA 94901

 

 

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