To join or renew membership, please make checks payable to Pine Grove Community House Send checks with completed form to P.O. Box 47, Manzanita, OR 97130.

Enclosed is a check for $____________($15 per person per year)  o New Member  o Renewal

Member name(s):______________________________________________________________

Address:_________________________________________________________________________________________________________________________________________________

Email:______________________________________Phone(home)______________________

(cell)___________________________Please indicate your preferred method of communication and notification (how would you like us to reach you):      Email o       Phone o      US Mail  o