Please print this form and mail it in with your payment 

 

 

 

 

  Checks must be payable to:
Antonio Toledo Memorial 
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