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: