Membership Form

Please send a check for $12.00 for a one year membership to:

	MMSG Membership
	8381 Castilian Drive
	Huntington Beach, CA  92646
and fill out the following info:


Please replace the Yes before each item with a No if you DO NOT wish that item to be made available to all MMSG members.

Yes No Your name:

Yes No Street:

Yes No Town / City:

Yes No County / State:

Yes No Post / Zip Code:

Yes No Country:

Yes No Home Phone:

Yes No Work Phone:

Yes No Fax:

Yes No Email 1:

Yes No Email 2:


Yes No Company you work for:

Yes No Special Interests or talents:



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