SCAS Member Form
SCAS Member Form
SCAS Member Form
Membership Information
Name: ________________________________ Address: _______________________________ ______________________________________ City, State, Zip: _________________________ ______________________________________ Phone: ________________________________ e-mail: ________________________________ (This information will not be made available to anyone outside the Sister Cities Association)
I am interested in the following opportunities: ___ Travel to Ashikaga ___ Travel to San Pedro ___ Hosting a visitor from Ashikaga ___ Hosting a visitor from San Pedro ___ Assisting with delegation planning ___ Board or committee membership ___ I/We would like to make an additional donation of $_______ to the Homer Butler/Terry Mast Memorial Fund.
I/We accept this invitation to join the Sister Cities Association of Springeld at the following level (please check one): ___ Student ($10) ___ Individual ($25) ___ Family ($35) ___ BusinessEnvoy level ($100) ___ BusinessAmbassador level ($250)
Please make checks payable to Sister Cities Association of Springeld. Send to: Sister Cities Association of Springeld P.O. Box 1474 Springeld IL 62705