PAC*SJ Printable Membership Form

Please fill out and print this form, and include it with your membership check to Join or Renew.

As an additional incentive for those who renew at the $100 level, you may request a copy of Signposts Revisited by Pat Loomis or you may select the just released PAC-SJ 20th Anniversary DVD.  Celebrate PAC-SJ's 20th Anniversary with a special DVD documenting many of our highlights of the past 20 years. Join at the $250 level and above and receive both the book and the DVD.

Membership Type:	Individual $40 Family $55 Senior (over 65) $25 Student $25 School $30 Non-Profit $30 Contributor $100 Small Business $100 Corporation/Patron $250 Benefactor $1,000
$100+ level Incentive:	Signposts Revisited Book PAC-SJ 20th Anniversary DVD none

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City
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Day Phone	- - x
Other Phone	- - x
E-Mail
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Referred By:

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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       Public Relations     Other:

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

Mail this form and your membership check to:
PAC-SJ History Park 1650 Senter Road San Jose CA 95112
OR call us at (408) 998-8105 and give us your credit card details over the phone: we take Visa, MC and American Express.
PAC*SJ is a 501(c) 3 non-profit organization - Non-Profit Tax ID:  77-0254542