Name: _______________________________

Street Address: ________________________

City, State, Zip _________________________

E-mail address: ________________________

As a member you receive:

• Newsletters

• Semi-annual published booklets of Essays and Articles on Columbia County History mailed to you

• Notices and reminders of upcoming events and activities

• Our appreciation, of course, as well as printed recognition if you wish

Dues are per calendar year. We respect your privacy but would like to recognize our members in our Newsletters, if you agree please indicate whether you would like to be publicly acknowledged as a member:

□ Yes, publish my name      □ No, Thank you

Annual membership dues are $20. Please enclose your check with this form and mail to:

CCMA

PO Box 172

Columbia City, Oregon 97018