El Dorado County Gem Club Logo
Placerville, California

El Dorado County
MINERAL and GEM SOCIETY
EARTH SCIENCES  - LAPIDARY ARTS  - SHARING INTERESTS

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Membership Application Request

Thank you very much for your interest in our gem club.

Please complete and submit the following information. We will send you an Application Form and Information about the Club by return mail.

Other ways to request information --

Write to us at: P. O. Box 950, Placerville, CA 95667
Leave a message: (530) 676-2472
Attend a meeting Senior Center, 937 Spring Street, Placerville

Information will be held in confidence and will not be used for solicitation.
REQUIRED FIELDS *

First Name *
Last Name *
Mailing Address *
City *
State *
Zip *
email *
Telephone *

PLEASE ANSWER THE FOLLOWING:

WHAT IS BEST TIME TO REACH YOU IF WE NEED TO VERIFY INFORMATION:
                  Daytime     Evening    Either

TYPE OF MEMBERSHIP YOU ARE CONSIDERING:
                Household (two or more)       Individual (adult)        Junior (only)

Would you like to receive emails about club activities in the future? Yes   No

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