African Association of Arizona by fYX8HZg

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									             AFRICAN ASSOCIATION OF ARIZONA


UNITY, FRIENDSHIP, AND TRUST

                                  AFASA Membership Form

New: _____ Renewal: _____            Dues/Amount paid ($50:00): $ _____________

Name: ____________________________________________________________________

Address: __________________________________________________________________

City: _____________________ State: __________ Zip Code: ______ Country: ________

E-mail Address: ____________________________________________________________

Home Phone: ________________ Work Phone: _______________ Cell Phone: ________

Countries of Affiliation/Interest in Africa: ________________________________________

__________________________________________________________________________


Why I am joining AFASA: ____________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________


Areas/Services through which I could be most helpful to AFASA:

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

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Signature: __________________________________ Date: ________________________




3454 North 51st Avenue, Suite 138, Phoenix, Arizona 85031 | (623) 247-4869 | www.afasa.org

								
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