Please print this page, fill it out with the appropriate information, and mail it to:

Chinese Culture Center of San Francisco
750 Kearny Street, 3rd Floor
San Francisco, CA 94108

Please make checks payable to the Chinese Culture Foundation.

Name: ______________________________________________________

Address:

____________________________________________________________

____________________________________________________________

____________________________________________________________

Daytime Phone: _______________________________________________

Evening Phone: _______________________________________________

E-Mail Address: _______________________________________________

Membership Class: _____________________________________________

Amount Enclosed: _____________________________________________

Thank you for your generosity and support to the CCC!