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Print this page out, fill it in, and send it (along with a check, please) to the address below. Alternatively, email the form below to us (copy and paste into your email client), and then send us a check (PO Box 2605, Santa Cruz, CA 95063). Your support is very much appreciated.
Phone: (831) 515-4101 Name: _____________________________________________________________ Address: _______________________________________________________ Telephone: _______________________________________________________________ Email: _______________________________________________________________ Particular areas of interest: Political Action • Programs • Outreach • Communications • Fundraising • Steering • Other _________ Enclosed is ___ for annual membership dues to help defray the cost of the work of the GLBT Alliance of Santa Cruz County (recommended amounts: $20 individual/$30 household). I support the Mission Statement of the GLBT Alliance of Santa Cruz County.
_______________________________________________________________ GLBT Alliance Steering Committee:
Thomas Leavitt, co-chair/webmaster |
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