Filipino American National Historical Society
FANHS - San Diego Chapter
Membership Form

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

Name:______________________________________
Address:________________________________________________
Telephone:____________________
City / State / Zip Code:________________________________
E-mail address: _________________________
Date __________

Please indicate type of membership (check mark):

Individual:		Family:
_ $25 - 1 year		_ $30 - 1 year
_ $100 - 10 years	_ $125 - 10 years
_ $250 - Lifetime	_ $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)

Filipino American National Historical Society
(FANHS) San Diego Chapter #18
P.O. Box 7135
Chula Vista, CA 91912
E-mail: fanhs18@yahoo.com
*Please make checks or money order payable to FANHS San Diego
Note: An additional $10.00 charge will be placed on checks returned