CCH Membership Renewal and Payment First Name*Last Name*Email*Select your membership LevelMembership Level*Select Membership Level – (click on the arrow to see menu of membership levels then click on the one desired)Individual Membership – One-year $35Individual Membership – Two-year $70Individual Membership – Three-year $100Household Membership – One-year $60Household Membership – Two-year $120Household Membership – Three-year $175Benefactor Membership – One-year $250Benefactor Membership – Two-year $400Benefactor Membership – Three-year $500Student Membership – One-year $15Payment Method*If you select the PayPal payment option, you will see a PayPal button at the bottom of the form which will submit your info and allow you to payPayPal CheckoutCredit Card MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number xxxx-xxxx Expiration Date MM/YY Security Code CVV I would be willing to serve on the CCH board of directors:Person completing this form Yes No Spouse/Partner First Name*Spouse/Partner Last Name*Spouse/Partner Name Email*I would be willing to serve on the CCH board of directors:Spouse or partner (household or benefactor only) Yes No I am willing to help with the following CCH committees – Member:Check all that apply. Audio/Visual Book Club CCH Archives Communications Community Outreach Membership Scholarship Social Sunday Brunch and Discussion Group Sunday Science Programs Sunday Science Refreshments I am willing to help with the following CCH committees – Spouse/Partner:Check all that apply. Audio/Visual Book Club CCH Archives Communications Community Outreach Membership Scholarship Social Sunday Brunch and Discussion Group Sunday Science Programs Sunday Science Refreshments Please use this space to let us know about: changes to your contact information (e.g. address, phone); special skills you can offer; other personal info or suggestions you’d like to share.Please use this space to let us know about: changes to your contact information (e.g. address, phone); special skills you can offer; other personal info or suggestions you’d like to share.EmailThis field is for validation purposes and should be left unchanged.
