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Alameda County Child Abuse
Prevention Council

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Membership

Download our membership form.



YEAR________

 

 

Individual Membership $20.00

 

Name: _______________________________________

 

Affiliation: ____________________________________

 

Address: ______________________________________

 

_____________________________________________

 

Telephone: ____________________________________

 

Fax: _________________________________________

 

 

Email address: _________________________________

 

 

Agency Membership $55.00

 

Agency Name: _________________________________

 

Contact: _______________________________________

 

Address: _______________________________________

 

______________________________________________

 

Telephone: ____________________________________

 

Fax: __________________________________________

 

Email Address: _________________________________

 

Make checks payable to: Alameda County Child Abuse Prevention Council,

and send check and form to:

Marcy Takeuchi, C201

Child Abuse Prevention Services Coordinator

Alameda County Social Services/DCFS

Eden Multi-Service Center

24100 Amador Way

Hayward, CA 94544

510-780-8989