Albuquerque Sister Cities Foundation Membership Application Form

Membership Application
Fields denoted with a red asterisk (*) are required

Personal/Organization Info

*First name:

Middle initial:

*Last name:

Organization:

*Address:

*City:

*State:

*Zip:

*Phone:

*Email:

Payment

*Name on card:

*Card number:

*CCV/CCV2:

*Card type:

*Card expiration:

Credit cards accepted...

What Are You Interested In?

Sister City

Ashgabat, Turkmenistan

Alburquerque, Spain

Chihuahua, Mexico

Guadalajara, Mexico

Helmstedt, Germany

Hualien, Taiwan

Lanzhou, China

Rehovot, Israel

Sasebo, Japan

Participation

Arts

Business

Education

Student

Teacher

Home Hosting

Public Relations

Other:

Revised March 2011


	Individual Adult	$20.00
	Young Adult (age 21-35)	$20.00
	Family	$30.00
	Individual Youth (age 13-20)	$7.50
	Senior Citizen (age 65+)	$10.00
	Small Business (15 or less employees)	$100.00
	Large Corporation	$300.00
	Non-profit organization	free exchange

*First name:
Middle initial:
*Last name:
Organization:
*Address:
*City:
*State:
*Zip:
*Phone:
*Email:

*Name on card:
*Card number:
*CCV/CCV2:
*Card type:
*Card expiration:

Annual Dues/Membership Type*

Personal/Organization Info

Payment

What Are You Interested In?