The Highway 50 Association
Membership

Application for renewal or new membership

Print this page, fill it out and send it in.

Signature_____________________________________________________

Name______________________________________ DoB: ____/____/____

Address______________________________________________________

City_______________________________________ State______________

Zip Code________________ Phone________________________________

___ $30.

___ New Membership        ___ Renewal

Checks to be made payable to and mailed to:

Highway 50 Association
Box 454
Placerville, CA 95667

Membership meetings are held the 2nd Tuesday of each month at 7:30 p.m.