Membership Registration Form
Name:
Your answer
Business Name:
Your answer
Business Website:
Your answer
Business Address:
Your answer
Phone Number:
Your answer
Cell Phone:
Your answer
Email:
Your answer
Best way to reach you:
MEMBERSHIP LEVEL
All memberships are valid for one calendar year January 1 - December 31. Please reference above for membership level details.
COMMITTEE SIGN UP
Please check at least one, or all that apply to your interests. I would love to help with the following committee(s):
PAYMENT METHOD
Cash or check payment can be delivered to Zip Code East Bay, 380 Colusa Ave, Kensington. Please make checks payable to: Colusa Circle Merchants Association. To pay online via PayPal, please use this link: https://paypal.me/colusacircle
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