MEMBERSHIP APPLICATION

	New Member Membership Renewal
Name
Prefix	Mr. Mrs. Dr.
E-mail
Tel./Fax
Profession/occupation
Postal Address
Basic Membership Category	Individual - $15   Family - $30   Corporate - $100
Friendship Membership Category (please, indicate the project you would like to support)	Friend - $100   Supporter - $500   Sponsor/Life times - $1000 or more
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