Hit Browser print function to print form:

:

UKCSC, 719 E. 3rd St., Cle Elum, WA 98922
                   Yearly Dues

Name: ___________________________________ Phone: ( ) __________________

Address: _________________________________ City: _________________________ Zip: ______

E-Mail: __________________________________ Birthday: __________ _______
                                                                                                                 Month            Day
Send newsletter via e-mail Circle one: YES NO