Last Name: ____________________First:_______________                                                          

  Address:__________________________________________

  City: ___________________________State: ______ Zip:__________

  Phone:__________________E-mail Address:_________________________

  Adult @ $80.00  ( After 5/31 - $85 )                       _______________

  Student @ $15.00 (must be full time and under 21 )  _______________________

  Family Plan @ $175.00   (2 parents and Children)  ( After 5/31 - $185 )    ___________________

  Single Family Plan @ $95.00   (After 5/31 - $100.00)  (single parent and children)   __________________

 Patron Plan Tax Deductible Donations

Platinum Angel: $1000            Gold Angel: $750  Patron $500        Benefactor $250         

Sponsor $100         Donor $50           Friend $25          Other:
 
Student Outreach Program $ _____________

  In Memory of: ______________________________
   Names of Donor will also be acknowledged

 TOTAL AMOUNT ENCLOSED $____________________

 Mail to: Membership VP,
Oxnard Community Concert Associations
  2060 Patricia St. Oxnard, Ca 93036
  Phone : 805-483-3858