APPLICATION FOR SPPC MEMBERSHIP
Please send your application to:
Society for Promotion of Persian Culture SPPC
P.O. Box 22381
Indianapolis IN. 46222
Date:
(Please select one)
CATEGORY OF MEMBERSHIP:
Family membership for parents and children under 18: |
$40 |
Student family membership for full-time students, spouse and children under 18: |
$20 |
Individual membership for adults: |
$20 |
Student individual membership for full-time students: |
$10 |
NAME ( last, first, middle, title ):
-Applicant: |
-Spouse: |
|
-Children (+age): |
1) |
2) |
3) |
4) |
5) |
-Address:
|
-Email: |
-Telephone (Home/Work): |
-Fax: |
-Annual Membership dues: |
-Donations to SPPC: |
|
Total: |
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