Online Sign-up Form
Welcome! Please print this page and fill it out, then send it to us via the U.S. Postal Service, fax to (530) 313-5143, or copy and paste the questions and answers into an email and send to firstname.lastname@example.org. Check all that apply. If you have further questions, just call (530) 493-2012 or email.
Don’t know how to “Copy and Paste?” Just read these instructions:
[ ] Please enroll me as a full member of The New 49’ers. My check or charge in the amount of $2,250.00 is enclosed for full payment (includes 10% discount for advance payment).
[ ] Please enroll me as a full member of The New 49’ers under the extended payment plan. Enclosed is my non-refundable down payment of $200. I understand that my balance of $2300.00 will be paid in the amount of $22.50 or more each month, commencing from this date.
[ ] Please enroll me as a New 49’er Associate Member for one year for $100. I will receive one FREE week of my choice per year (between 1 May and 30 September) on the New 49’er claims; I am also invited to attend any or all of the Club’s scheduled weekend group mining projects at no charge, and receive the 49’er newsletter.
[ ] Please send me your free 30-minute video.
Credit card number:
[ ] M/C [ ] Visa Expiration Date of card
Name on Card (Print): ________________________
Today’s Date: _______________
Member’s Name: _______________________________________________
Member Address: _____________________________________________
Member Town or City: ____________________________
State: ________________________________ Zip: _______________
Daytime Telephone #: __________________________________________
Home phone if different: ________________________________________