| PRINTABLE MEMBERSHIP RENEWAL FORM |
|
| Print this page, then mail the completed form along with your dues payment. | |
| Please mail your check payable as follows: | |
|
CCGO c/o The Arnold Law Practice
3620 Happy Valley Road, Suite 101 Lafayette, CA 94549 |
|
|
|
||
|
Name of Contact:
|
|
||
|
Mailing Address:
|
|
||
|
City:
|
|
||
|
State, Zip:
|
|
||
|
Email:
|
|
||
|
Phone:
|
|
||
|
Fax:
|
|
||
|
Web Site Address:
|
|
||
|
Membership Dues:
(Please Refer to Chart Below) |
|
||
|
Voluntary Contribution:
($50 recommended) |
|
||
|
Total Dues:
(Sum of Dues and Contribution) |
|
|
|
||
|
Fewer than 50
|
$100
|
||
|
51-100
|
$150
|
||
|
101-150
|
$275
|
||
|
151-200
|
$350
|
||
|
201-250
|
$500
|
||
|
More than 250
|
$600
|
