Filipino-American Association of Iowa by rur27363

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									                              Filipino-American Association of Iowa
                                       Membership Application


Last Name _________________________First Name _________________________________
                                                             (include name of both spouses if family member)
Address _____________________________________________________________________
              Street                   City                   State          Zip code
Telephone _(______)_______________________ [ ] check here if unlisted
Email address: _________________________________________________________
Dependent children’s name (include ages) ___________________________________
______________________________________________________________________

[    ] member (individual - $20.00/yr)      [     ] family ($28.00/yr)         [   ] senior member **
                                           w/ children below 18 yrs old
    Please make a check mark on the areas where   you can help:
    [ ] food committee                             [ ] equipment & photography committee
    [ ] decorations committee                      [ ] fundraising & solicitation committee
    [ ] public relations & welcoming committee     [ ] calling tree committee
    [ ] event clean up committee                   [ ] program & entertainment committee
    [ ] scholarship program committee              [ ] LAHI staff, Contributing Editor

Make check payable to: Fil-Am Association of Iowa
Mail form & check to: c/o Maria R. Collins, Treasurer               **Senior member must be 62 or
                      227 E. Dunham, Des Moines, IA 50315           over or a spouse of a qualified
                                                                    senior member.
???? call Alma Reed @ 515-989-0417
                                Filipino-American Association of Iowa
                                    Membership Application 2006


Last Name __________________________First Name ________________________________
                                                               (include name of both spouses if family member)
Address _____________________________________________________________________
              Street                   City                   State          Zip code
Telephone _(______)_______________________ [ ] check here if unlisted
Email address: _________________________________________________________
Dependent children’s name (include ages) ___________________________________
______________________________________________________________________

[    ] member (individual - $20.00/yr)      [      ] family ($28.00/yr)          [   ] senior member **
                                                  w/ children below 18 yrs old
    Please make a check mark on the areas where   you can help:
    [ ] food committee                             [ ] equipment & photography committee
    [ ] decorations committee                      [ ] fundraising & solicitation committee
    [ ] public relations & welcoming committee     [ ] calling tree committee
    [ ] event clean up committee                   [ ] program & entertainment committee
    [ ] scholarship program committee              [ ] LAHI staff, Contributing Editor

Make check payable to: Fil-Am Association of Iowa
Mail form & check to: c/o: Maria R. Collins, Treasurer                **Senior member must be 62 or
                      227 E. Dunham, Des Moines, IA 50315             over or a spouse of a qualified
                                                                      senior member.
??? call Alma Reed @ 515-989-0417

								
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