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To join CSLA, please print, fill in, then mail the form below. Don't forget to mail a check or money order in U.S. dollars for the total membership
dues to:
CSLA
P.O. Box 19357
Portland, OR 97280-0357
Please circle where you wish CSLA mail sent: Home - Church - Synagogue.
Name: ___________________________________________________________
Address: __________________________________________________________
City: ________________________ State/Province: _________ Zip: ___________
Church/Synagogue: _________________________________________________
Address: __________________________________________________________
City: ________________________ State/Province: _________ Zip: ___________
Name of Representative: _____________________________________________
Home Phone: _________________ Church/Synagogue Phone: _______________
Fax: ________________________ E-mail: _______________________________
Please send information about the nearest CSLA chapter (circle one): Yes
/ No
Check membership desired (prices are for January-December):
____ Individual U.S. $35
____ Individual Canadian/Foreign $40
____ Church/Synagogue U.S.
$55
____ Church/Synagogue Canadian Foreign $60
____ Affiliate $95
____ Institutional $200
____ Contribution to CSLA $_________
Total (U.S. Dollars) $ ___________
$10 charge for returned checks
Please tell us how you heard about CSLA?_____________________________
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