FILL OUT FORM,
THEN PRINT IT
,
ENCLOSE CHECK MADE OUT TO OCHS AND
MAIL TO: JUDY MOORE, 1900 W GLENOAKS, APT C. ANAHEIM, CA, 92801
HOME
NAME
ADDRESS
CITY
STATE, ZIP
PHONE
E MAIL
FOR MEMBER LEVEL
CHECK
$20.00
INDIVIDUAL
$35.00
FAMILY (same address)
$60.00
SPONSOR
$100.00
PATRON
$300.00
LIIFE
$40.00
INSTITUTION
$200.00
CORPORATE
AMOUNT ENCLOSED