MEMBERSHIP APPLICATION

 

DUES

 

 

 q  I would like to become a member of the H.H.I.  Enclosed please find my check in the amount of  $____________.

 

 q  I would like to make an additional donation in the amount of:________.

 

ANNUAL MEMBERSHIP:

 

 q  Single:     $60.00            

  

 q  Family:   $80.00

 

 Name:     _________________________________________________________

 

Address:  _________________________________________________________

 

Telephone (work):   ________________________________________________

 

Telephone (home):  ________________________________________________

 

E-mail address:        ________________________________________________

 

 

PLEASE RETURN THIS FORM TO:

Hellenic Heritage Institute

1650 Senter Road, San Jose, CA  95112