Membership Form
- التفاصيل
- نشر بتاريخ الخميس, 23 شباط/فبراير 2012 21:58
Sudanese American Development Organization (SACDO)
Membership Form
5622 Columbia Pike. Suite #305 Falls Church, VA 22041 Phone : (703) 575-4473 Fax: (703) 575-4473
P.O. Box 151 201 W. Broad Street Falls Church , VA 22046 http://www.sacdo.com
I, undersigned, hereby certify that I approve and adhere to the Declarations of principles and ask that my name be inscribed in the Sudanese American Community Development Organization (SACDO) Membership Book
Signature:
Do you want your name & address to be included and published in the SACDO Directory?
Date:
Last: Last:
First Name: Middle: Spouse First Name: Middle:
Home Address:
Address1: :
City: State: Phone-1: Mobile:
Email:
Dependent Information (18 years or less):
First Name Last Name
Zip Code:
Sex
Date of Birth
Payment Enclosed:
Amount ($): Cash or Check?
If Check, Check #?
Fees : payable to SACDO's Treasurer by cash receipt, Check, Money Order or Cashier's check mailed to the above address. Registration fees $10. Dues $5 (Individual) or $10 (family) per month, payable annually, biannually, quarterly or monthly. If annually, dues are only $50