Print the form; send the completed form to the address below with your dues.

Name: _________________________________________Date:___________________

Mailing Address: _________________________________________________________

Town, State, Zip: _________________________________________________________

Phone Number: __________________________________________________________

E-Mail Address: __________________________________________________________
 

Annual Membership Dues:

$   5   _______ Individual 
$ 10  _______ Family 
$ 25  _______ Business 

Mail to PGCIC, P. O. Box 284, Pine Grove, CA 95665.

The Pine Grove Civic Improvement Club meets the first Wednesday of the month at the Town Hall. Meetings start at 6:30 p.m. and are open to anyone who wishes to attend.