Home of The Santa Clara County Tenants Association

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Name:

Address:

Address 2:

City:

Zip Code:

Telephone:

Fax:

Cell:

E-mail Address:

How Much is your Rent?:
Less than $800.00
$800.00-$900.00
$900.00-$1,100.00
$1,100.00-$1,300.00
$1,300.00-$1,500.00
$1,500.00-$1,700.00
$1,700.00-$1,900.00
$1,900.00 or more
I don't care to answer this one!

Would you be interested in learning more about Rent Control?:
Not Very   Somewhat   Quite   Very  

Would you be interested in helping to sign up new members?:
Not Very   Somewhat   Quite   Very

Would you like to be informed of future events and activities?:
Yes   No Maybe

Would you be interested in making a donation?:
Yes   No Maybe

Comments:


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this page was last updated on 01/20/02