Contact Information |
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Name |
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Street Address |
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City ST ZIP Code |
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Home Phone |
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Work Phone |
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Mobile Phone |
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E-Mail Address |
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Membership Type |
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___ Student/Resident Alien |
___ Individual |
___ Organizational |
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Fee Schedule: · $20 for students and resident aliens · $50 for individuals · $100 for churches or organizations with an annual budget from $0 - $250,000 · $250 for churches or organizations with an annual budget from $250,000 to $500,000 · $500 for churches or organizations with an annual budget over $500,000 Membership is from January 1 - December 31 of the year in which you make your payment. |
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Amount Enclosed: ___________________________________ |
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Please send this form and your payment made payable to: |
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AFRECS 3737 Seminary Road Alexandria, VA 22304 |