PAC*SJ Printable Membership Form

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

Join or Renew.  Memberships at the $100 level or up and receive a choice of:
  • A copy of Signposts Revisited by Pat Loomis, or;
  • The PAC-SJ 20th Anniversary DVD documenting highlights of the past 20 years, or;
  • One deck of Mid-century Modern playing cards.

Membership Type:
$100+ level Incentive: 

ZIP Code
Day Phone
- - x
Other Phone
- - x
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
      Public Relations
I would be interested in serving on:
      Advocacy Committee
      Fundraising Committee
      Education Committee
      Membership Committee
Mail this form and your membership check to:
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