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Membership Form

Filipino-American Association of the Inland Empire

Membership Application Form

Please mail your completed application form with your $20.00 fee (check / money order) to our Membership Coordinator, Jonna Langevin, 6509 S. Sandstone Street, Spokane, WA 99224. Thank you!

Date_______________________ Paid by  ____ Cash ____ Check ____ MO

Name___________________________________________

Spouse Name ____________________________________

Address _________________________________________

________________________________________________


Best Phone Number to Reach At _(_______)_________________________  Cell ___ Home___

Alternate Phone Number  _(_______)_______________________Cell ___ Home___ Spouse __

Your Email Address ________________________________________________

Spouse Email Address ______________________________________________

Are You on _____ Facebook  _____ Twitter _____ Linked In


Family Members Living with You At Home

Names __________________________________ Relationship _____________

Names __________________________________ Relationship _____________

Names __________________________________ Relationship _____________

Names __________________________________ Relationship _____________

Province and Dialect _______________________________________________


Areas of Interests/Skills: Please check ALL that apply.

____ Leadership                      ______ Dancing           ______  Public Relations

____ Event Management         ______ Singing            ______  Maintenance

____ Computer                        ______ Cooking           ______  Auto Mechanic

____ Public Speaking              ______ Creativity         ______  Cashiering

____ Written Communication   ______  DJ                  ______  Bookkeeping


Would you allow FAAIE to publish your name and contact information in our Annual Directory?  YES _____   NO  ______






 

 


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