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Company: ________________________________________
Service Type: ( ) Receiver ( ) Attorney ( ) CPA/Accountant (
) Other ___________________________
Representative:____________________________________
Address:__________________________________________
City:_____________________________________________
State:____________________________________________
Zip:_______________________
Phone:_____________________
Fax:_______________________
Email:_____________________
Individual Membership …………………………………………….$
60.00
Corporate Membership.....................................................................$200.00
Corporate
Memberships allows for up to four Members, to include additional representatives on the membership
roster or make changes to the current members, please list below:
Name:
Email Address:
Please remit payment
to:
California Receivers Forum, Bay Area Chapter
Attn: Jodi Owens
P O Box 1838
San Leandro CA 94577
Phone
(510) 346-6000 ext 221 Fax (510) 346-6020 |
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