Name ______________________

Business_______________________

Address ___________________________________

______________________________________________

Phone_H:_______________W:_______________

E- Mail ______________________________________
 

Enclosed are  my dues for a one year membership with the Taxpayer's League.

Signed_________________________________

I would be willing to work with one of the following committees:

___Membership   ___Legislative   ___Budget   ___Current Issues

Complete and mail this form to: Humboldt Taxpayer's League, PO Box 1432, Eureka, CA 95502