Membership Application/Renewal Form

To join or renew, fill in this form, print and send with your check to:
SLOCGS Membership
760 Avocet Way
Arroyo Grande, CA 93420

Membership Type (Check one)
Yearly Individual: $22

Family [for existing Family Membership renewals only]: $26
Multi-year Individual: $20 times # of years

Family [for existing Family Membership renewals only]: $26 times # of years
Lifetime Individual: $264

Supporting: $500

Benefactor: $1,000
Dues are for a period of one year from the date of payment.
Your canceled check is your receipt.

Name and Contact Information
Name:
Address:
City & state:
ZIP + 4:
Area code & phone:
Email address:
Do you want a Membership Card? Yes No
For Society's Use: ID# _____ Log # _____ Cash _____ Check #____ Amount ____

Date _________ New Exp. Date ___________