Membership Form To join SECWAC for the 2015

Transcription

Membership Form To join SECWAC for the 2015
SOUTHEAST CONNECTICUT WORLD AFFAIRS COUNCIL
Dedicated to educating and engaging Americans on
global issues
Membership Form
To join SECWAC for the 2015-2016 Speaker Series Season, please print, complete and
mail this form to:
SECWAC
914 Hartford Turnpike
Suite 206
Waterford, CT 06385
I/We would like to be members of the Council, and enclosed is a check payable to
SECWAC for $____________ ($75 is the annual fee for each member)
(Please print all information clearly)
Name of each member:
____________________________________________________
____________________________________________________
Address: ____________________________________________
City:_______________________________________________
State:_________________________Zip:__________________
Email:_____________________________________________
Phone:____________________________________________
For additional information:
Call: 860-912-5718
Email US at: info@SECWAC.org
A Proud Member of: