Jurupa Mountains Cultural Center
(Please print out this form and mail to the address below.)
J.M.C.C.
Membership Form
Name______________________________________________________
Address____________________________________________________
City________________________________State________ZIP_________
Phone Numbers: Work__________________Home___________________
Type of Membership:________________________Amount $____________
Circle one: Visa - MasterCard - Discover
Card Number____________________Exp. Date:_____/_____
Signature:_____________________________________
Please make checks payable to JMCC. Memberships are deductible for income tax purposes to the full extent provided by law. The membership year for new members begins upon the date the application is received and processed.
Office use only. Membership #_________ Rec#_________ Exp. Date _____/_____
Mail To:
ATTN: Membership Coordinator
JMCC - 7621 Granite Hill Drive
Riverside, CA 92509
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