Become a Member of Call to Action of Michigan
or Renew Your Membership Today!

Mail this form to CTA of Michigan, P.O. Box 12161, Hamtramck MI 48212-2764

SUPPORTING MEMBER:   ___ $100  ___ $75  ___ $50   ___ $35   Other:  $ _____
REGULAR MEMBER:  Single Membership  ___  $20  ( $1-19 limited income)
                                     Household Membership:  ___  $35 ($1-34 limited income)
Please check one:   ___ New       ___ Renewal

 Dues for the calendar year are billed in May each year. If you have paid dues since January 1 of the current year, you are paid for the entire year. Make checks payable to CTA of Michigan. Contributions are tax deductible.   

 Last Name   ______________________________     First Name ______________________________________
(If household please list both names)  

Address   ___________________________________________  

City ______________________________ State ______ Zip ____________

Home phone   _______________________________        

Work phone  (      )  ____________________________________

Email __________________________________       

Fax  (     ) _______________________________

Branch affiliation if any (if any)  ___________________________

 All donations are tax-deductable!
Make checks payable to "Call to Action of Michigan".      THANK YOU!