SMCLSA MEMBERSHIP DUES RENEWAL 2008-2009

Membership renewal due May 1, 2008 and delinquent May 31, 2008

Make checks payable to SMCLSA.  Send check to:

Nancy O'Shea, CCLS

600 E. Weddell Drive, Spc. 51

Sunnyvale, CA 94089

Even if your information has not changed from last year, please complete the form below and include with your check. Please print or type the information.

Name:                                                                                                                                                         

[   ] Active [   ] Retired [   ] Student [   ] CCLS [   ]   PLS [   ] Honorary Life Member 

Birthday (Month & Day only)                                                                                                                       

Residence Address:                                                                                                                                      

Street Address: City _______________________________________Zip Code                                         

Home Telephone:) (        )                                      Home E-mail:                                                                    

Employer:                                                                                                                                                     

Employer’s Address:                                                                                                                                    

Work Phone: (         )                       Fax:  (     )                          E-mail:                                                       

DO YOU PREFER E-MAIL TO YOUR HOME [     ] or OFFICE [      ]