[ ] | Yes! I want to support CAMC and its work by joining
the CAMC.
My name ____________________________________________
Address ____________________________________________
City ________________ State _____________ Zip ____________
Tel: _____________________ Fax: _________________________
Email: _________________________________________________
|
[ ] | Enclosed is my annual
contribution [ ] gift [ ] membership [ ]
to help CAMC for its endeavour:
( ) $1,000 | ( ) $500 | ( ) $100 |
( ) $ 50 | ( ) $35 | ( ) Other $_________ |
|
[ ] | Please place me on your Volunteer Force on availability-need basis.
|
[ ] | I wish to explore additional avenue(s) to help and support CAMC more. |
[ ] |
I am a registered voter: | ( ) Democrat | ( ) Republican |
| ( ) Independent | ( ) Other________ |
|
[ ] | I am not a registered voter. Please assist me to register. |
[ ] | I want to become a U. S. citizen. Please assist me. |
[ ] | I wish to have a meeting/meetings with CAMC member(s) to know more
about it and its work. |
[ ] | I wish to disclose in advance a potential conflict of interest in working with
CAMC. Please let me have an opportunity to declare it. |
N. B. | Please kindly return your completed form to Secretary. Thank you. |