| Santa Cruz Bird Club | ||
| Membership Application Form | ||
| Name: _________________________________________________ | ||
| Address: _______________________________________________ | ||
| City: ___________________________________________________ | ||
| State: _________ Zip: __________ Phone: _____________________ | ||
| Email address: ____________________________________________ | ||
| I am renewing my membership _____ I am a new member _____ | ||
| Individual______ Family ______ Youth (under 16) ______ | ||
| Annual Dues: Individual: $20; Families: $25; Youth: $5 Lifetime $400 | ||
Please mail to: Membership Chair
Santa Cruz Bird Club
Box 1304
Santa Cruz, CA 95060