Please print this form and mail it in with your payment 

 

 

 

 
  Checks must be payable to:
JOSE ANTONIO TOLEDO 
5938 Joaquin St
Chino, CA  91710		   Address on the left fits in a
regular size window envelope.
 
 
 
 

 

 

 
Check Number                      Check  Amount 
 

 

 

 
 
2016 Membership Dues - $60