Membership Form
**Please complete and mail to:
FANHS San Diego Chapter | P.O. Box 7135 | Chula Vista, CA 91912

Name: __________________________________________ Date __________

Address: _______________________________________________________

City/State/Zip Code:_______________________________________________

Telephone: _______________________ E-mail address: _________________

__ add me to your email notification list

Please indicate type of membership (check mark):

    Individual:
    __ $25 - 1 year
    __ $100 - 10 years
    __ $250 - Lifetime
    Family:
    __ $30 - 1 year
    __ $125 - 10 years
    __ $275 - Lifetime
    Student
    __ $5 - 1 year
    Senior (over 65)
    __ $5 - 1 year

I would like to be involved in the following:

__ Photo Collection
__ Archival / Records
__ Research __ Lectures
__ Oral History __ Writing

Unfortunately, I cannot be an active member at this time.
However, I would like to donate the following amount
to the FANHS San Diego Chapter:

$______.____ (Donations are tax-deductible)


**Please make checks or money order payable to FANHS San Diego
Note: An additional $10.00 charge will be placed on checks returned

Filipino American National Historical Society
(FANHS) San Diego Chapter #18
P.O. Box 7135
Chula Vista, CA 91912


FANHS-SD application reference number
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