Membership

Please complete the information below.

Membership Options:
$10 Student (fulltime)
$20 Senior (60+)
$30 Individual
$50 Family/Dual
$75 Benefactor
$125 Patron
$500 Individual Life
$1,000+ Corporate Life
Name:
Address:
 
City:
State:
Zip Code:
E-mail:
Phone:

Please make check payable and mail to:
   Placentia Founders Society
   136 Palm Circle
   Placentia, CA 92870