Join ASC and help make a difference

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Please join ASC in our efforts to unify our communities so we can work together to remove obstacles to peaceful, respectful, healthy and completely integrated lives. The information you provide on this form is strictly confidential and will only be available to the ASC Board of Directors for authorized purposes.

Date:
First Name: Last Name:
Address1:
Address2:
City: State: Zip:
Contact Phone: Email:

I would like to serve:

On A Standing Committee
By Doing Information Distribution
On a specific project
As a Board Member
Other (we will call you for details)
Multiple items may be chosen.

I would like to make the following donation:
(You will be billed at the above address for your donation)

Organization $25-100
Family $20-60
Individual $15-50
Other

Comments:

Thank you for the time you have taken to become an active member of our community.
We look forward to seeing you at our next meeting.


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