Membership Renewal and
Information Update

Pleasanton Mothers Club
Membership Renewal and Member Information Update Form

Membership dues are $35.00 per year if you are renewing between June 1 - November 30. If you are renewing between December 1 and May 30, the dues are $20.00 for the remainder of the year. Returned checks will be subject to a $5.00 fee.

If you have any questions, please contact our Membership Coordinators.
*YOU MUST FILL IN ALL FIELDS MARKED *
*First Name:
*Last Name:
*E-Mail Address:
*Phone #:
Address:
New Additions to the Family - Please specify name, birthday, gender:
I am: I am renewing my membership ONLY.
I am updating my information ONLY.
I am renewing my membership AND updating my information.