PAC*SJ Online Membership Form

Name
Street
Apt./Ste.
City
State
ZIP Code	-
Day Phone	- - x
Other Phone	- - x
E-Mail
Organization
Referred By:

Email me about upcoming events?
Yes    No

PAC*SJ will not release your contact details to third parties without your consent.
Please check if would like us to not publicize your name as a PAC*SJ member.
      

I would be interested in Volunteering (please check any of the following):
      Serving as a Board Member
      Working at events or tours
      Testifying at public meetings
      Writing articles for the Newsletter
      Pro bono legal assistance
      Service Learning Partnership
      Public Relations
    Other:  

I would be interested in serving on:
      Advocacy Committee
      Fundraising Committee
      Education Committee
      Membership Committee