CCC Renewal

Please print out, then mail completed form to
Channel City Club, P.O. Box 60602, Santa Barbara, CA 93160-0602.

Date:

Member Name(s):

Mailing Address:

Telephone (Res.):

(Cell):

Email Address:
Do you prefer email communication for Speaker Notices?

DUES (Click here for Dues Page)
Annual Dues $:
Total Amount $

Payment Information:
o Check enclosed (Please make check payable to the CCC.)
o Credit Card

{ } Mastercard { } Visa Card#

Exp.

Amount $

Authorized credit card signature

If you have any questions or wish additional information, please call us at 884-6636 or email ChannelCity@Earthlink.net.
Non profit 501 (c) organization. Thank you for your support!