CSPA Membership Form

Return to the CSPA website
Please print this on-line form and mail it along with your donation. Thank you!

Mail to: California Sportfishing Protection Alliance
6597 Cane Lane, Valley Springs, CA 95252
www.CalSport.Org

Yes, I want to join _____ renew _____ my annual CSPA membership.

Individual: Please allow 10 days for shipping of membership premiums

___$30 ___$50 (Hat) ___$75 (Shirt, Circle - s, m, l, xl ,2xl) ___ $100 (Hat, shirt, Circle - s, m, l, xl ,2xl)

___ $150 (Jacket, Circle - s, m, l, xl ,2xl) ___ $250 (Hat, shirt, jacket, Circle - s, m, l, xl ,2xl)

___ $500 or more (multiples of the above premiums, Size for shirt/jacket, Circle - s, m, l, xl ,2xl)

Businesses/NGOs/Clubs/Affiliates: Please allow 10 days for shipping of membership premiums

___ $100 (Hat, shirt, Circle - s, m, l, xl ,2xl) ___ $150 (Jacket, Circle - s, m, l, xl ,2xl)

___ $250 (Hat, shirt, jacket, Circle - s, m, l, xl ,2xl) ___ $500 or more (multiples of the above premiums, size?)

Benefactors: Please allow 10 days for shipping of membership premiums

___ $1,000 ___ $5,000 ___ $10,000 or more (Please contact the webmaster for premiums needed, size?)

Name:_________________________________________________________________

Organization or business:_______________________________________________

Address:_______________________________________________________________

City: ____________________________ State: _______ Zip: ____________________

Phone:_______________ Fax: ________________

E-mail:________________________________

Yes I would like my name/business/organization listed on the donors page! _____

Yes, I would like a FREE link to my personal/business/organization website! _____

URL of website:___________________________________________________________________

No, I wish to remain anonymous and do not wish a listing. ____ TOTAL $_____________________

Payment made by: ____ Cash ____ Check (# ________) _____Credit Card: Credit Card Information:

__________	// ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___	// ___ ___/___ ___	// ___ ___ ___
Type	16 digit number	Exp. mo/yr	Sec. Code

I agree to the above purchase using the supplied credit/debit card. I understand the charge will be made via PayPal:

Signature: ________________________________________________________________________

The California Sportfishing Protection Alliance is non-profit, tax deductible,
public benefit organization as described in section 501(c) (3) of the Internal Revenue Code.
Your gifts are deductible to the full extent of the law.