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Renewal Form
    Member Information
  1. Please enter your name, email address, and select your membership type.

    All other fields are optional - please only enter the fields which have changed.

    If you would prefer, you can also mail your check to CCPAS, 2100 Tice Valley Blvd, Walnut Creek, CA 94595

    Note : These fields are required: (*)
  2. First Name:(*)
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  3. Last Name(*)
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  4. Email address(*)
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  5. Please acknowledge reading the Volunteer Form.
  6. Volunteer Area (*)
    Please enter the Volunteer Area.
  7. The following entries are only required if they have changed from those in the Directory.

  8. Name of Organization/Firm (if applicable)
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  9. Street Address
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  10. Apt #
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  11. City
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  12. State
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  13. Zip
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  14. Home phone
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  15. Cell phone
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  16. Do you want to be listed in the Directory?
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  17. Receive newsletter by
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  18. Sending the newsletter by email saves PAS printing and mailing costs. Your email address is used only for sending the monthly newsletter and critical event updates - your privacy is important to us.
  19. Invalid Input
  20. Please select up to 4 musical interests :
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  21. Invalid Input
  22. Please select your primary instrument(s). (Up to three may be selected ).
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  23. Invalid Input
  24. Invalid Input
  25. Invalid Input
  26. Voice Range:
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  27. Invalid Input
  28. Invalid Input
  29. Invalid Input
  30. Second Family Member
  31. First Name:
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  32. Last Name:
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  33. Cell phone:
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  34. Email address:
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  35. Invalid Input
  36. Please select up to 4 musical interests :
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  37. Invalid Input
  38. Please select this family member's primary instrument(s). (Up to three may be selected ).
    Invalid Input
  39. Invalid Input
  40. Invalid Input
  41. Invalid Input
  42. Voice Range
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  43. Third Family Member
  44. First Name:
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  45. Last Name:
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  46. Cell phone:
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  47. Email address:
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  48. Invalid Input
  49. Please select up to 4 musical interests :
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  50. Invalid Input
  51. Please select this family member's primary instrument(s). (Up to three may be selected ).
    Invalid Input
  52. Invalid Input
  53. Invalid Input
  54. Invalid Input
  55. Voice Range
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  56. Fourth Family Member
  57. First Name:
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  58. Last Name:
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  59. Cell phone:
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  60. Email address:
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  61. Invalid Input
  62. Please select up to 4 musical interests :
    Invalid Input
  63. Invalid Input
  64. Please select this family member's primary instrument(s). (Up to three may be selected ).
    Invalid Input
  65. Invalid Input
  66. Invalid Input
  67. Invalid Input
  68. Voice Range
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  69. CCPAS Membership Type(*)
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  70. Optional tax-deductible donation
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  71. Total
    0.00