Membership Form

South Shores Community Association Membership Form
All information will be held in strictest confidence.

Name(s): _________________________________________________________________________________________

Address: __________________________________________________________________________________________

Telephone: ______________________________________________________________________________________

Email: ____________________________________________________________________________________________

Membership Type (circle one):

New Member         Renewal         Pre-paid (2+ year membership)

Level (circle one):

1 Year ($20)         2 Years ($40)         3 Years ($60)         4 Years ($80)         5 Years ($100)

Mail this completed form with your check to:
South Shores Community Association, P.O. Box 922, San Pedro, CA 90733