CEC at RB

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CEC-RB Membership Application
Effective through June 30, 2012

Print and fill out this form

Membership Information:

Name(s)		__New ___Renewal
		__New ___Renewal
Address
City, State, Zip
Phone (with area code)
E-Mail Address

Individual membership	____ $30 per year
Family membership	____ $50 per year
Sustaining Individual	____ $150 per year

Volunteering Opportunities	____ Lecture registration ____ Special events ____ Office assistance ____ News mailings ____ Leadership position ____ Audio Visual

Instructions:
1. Print this page with your web browser
2. Enter your information and the membership type, individual or family
3. Check off any volunteer activities you'd like join in
4. Make your check payable to: CEC/RB
4. Mail to CEC/RB, PO Box 28099, San Diego, CA 92198-0099

For additional information, phone 858-487-0464