Building a Better Redondo Membership Form

Membership Form for Building a Better Redondo
BBR is a non-profit PAC # 1283634

To become a member of BBR, please complete the following information and send this form, along with a check made payable to Building a Better Redondo, to: BBR HQ, 602 South Broadway Ave, Unit B, Redondo Beach, CA 90277

___ New Member ___ Renewal ___ Gift Membership*

First Name __________________________ Last Name ___________________________

Mailing Address _______________________________________________________________

Email Address ________________________________________________________________

Basic - $25___ Student - $12 ___ Senior - $18___ Family - $35 ___
Gold - Platinum Levels $ _______ Patron $ _______

Total Enclosed: $___________

Occupation & Phone No: (Needed if your Total is over $100.00) _________________________________________
_________________________________________

*If this membership is a gift for someone, please include the recipients information above and list your information here:

First Name ______________________________ Last Name __________________________________________

Mailing Address ______________________________________________________________________________

Email Address ____________________________________________________________________

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