Becoming a Member of tacam
v e r s ion 5 – o c t 2 0 0 9 e a
Becoming a Member of tacam
Household Information
family last name
home phone
street address
city
state / province
zip / postal code
city
Member Information
member names
first, last (If different)
birth date e-mail address
mm / dd / yyyy
(Optional) S E LF
Membership Payment and Donation Information
sex
relationship S POU S E C HILD
O T HE R
M
F
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2 ________________________________
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3 ________________________________
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4 ________________________________
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5 ________________________________
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I am enclosing a check for my membership dues for this calendar year. Your membership will begin that day your payment is processed and last a full year from that date. Please make checks payable to tacam and mail to: tacam Membership, p.o. Box 3445, Farmington Hills MI, 48333-3445. ◯
$100.00 Family (including children under 18)
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$50.00 Single Adult > (qty. _______
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$25.00 Student (18 and over) > (qty. _______ x $25.00) >
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I am enclosing a donation for the Turkish School for >
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I am enclosing a donation for the Building renovation project for >
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I am enclosing a donation for the Anatolian Voice (newsletter) for >
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I am enclosing a donation to tacam for >
x
$ ___________ . ____
50.00) >
$
$ ___________ . ____ $ ___________ . ____ $ ___________ . ____ $ ___________ . ____ $ ___________ . ____ $ ___________ . ____ total enclosed $ ___________ . ____
FOR INTERNAL USE ONLY - DO NOT WRITE IN THIS S PAC E
MEMBER # __________ V5 09
CHECK # ___________________________
MEMBER SINCE ____________
DATE POSTED & INITIALS ________________