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Chinese Association of Iowa
Membership Registration Form 2005

Please send your check to:     Chinese Association of Iowa
                                                Treasurer's Office
                                                5213 Cody Dr.
                                                West Des Moines, IA 50235

Question about the membership, contact: (Tel) 515-222-0379 or [email protected]
                                              

I (We) would like to become a member (members) of Chinese Association of Iowa to support cultural diversity and promote Chinese culture in Iowa.

Today's Date

Name

Family Member Name(s)

Mailing Address

Contact Email(s)

Contact Phone(s)

Membership Fee (check one)

Individual                                                        $10

Family and Non-profit Organization       $25

Business                                                            $50

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Page updated: March 25, 2005