CSCA Membership – Authorize4 CSCA Membership "*" indicates required fields Corvallis Sister Cities Association Membership FormName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Registration Type*New MembershipRenew MembershipLevel* Individual - $20 Family - $35 Friend - $50 Sustaining - $100 Patron - $200 I would like to be involved with Gondar Uzhhorod Both I would also like a "I support CSCA" yard sign a receipt for a tax deduction CommentsTotal Donation Option I'll pay credit card fees so 100% goes to CSCA. Credit Card Fees Price: $0.00 Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Security Code Cardholder Name CAPTCHAPhoneThis field is for validation purposes and should be left unchanged. Δ
