TSCA PUGET SOUND MEMBERSHIP
FORM |
I wish to: |
Join
|
Renew
|
Change my address/info
|
Check one: |
National Only (rates below)
|
Chapter Only
(No Dues)
|
National + Chapter (Rates below)
|
Individual/Family ($20 annually) |
Patron ($100 annually)
|
Sponsor ($50 annually) |
Canadian with Airmail Mailing
(US$25 annually)
|
Sponsor with 1/8 page ad ($60
annually) |
Other Foreign with Airmail
Mailing (US$30 annually)
| |
Enclosed is my check for
$______________________________ made payable to TSCA. |
| Name
___________________________________________________________ |
| Address
___________________________________________________________ |
Town
_____________________________________________
State _______ ZIP ________________ |
E-mail
_____________________________________________
Phone __________________________ |
Mail to: TSCA Puget Sound, c/o John Weiss,
19222 37th Ave NE, Lake Forest Park, WA 98155 |
| Note: Individual and Family Memberships
qualify for one vote and one copy of each TSCA mailing.
Family Memberships qualify all members of the immediate family
to participate in all other TSCA activities. |
I prefer to receive announcements &
notices via: E-mail
Web site Snail mail
|