Membership Application

 

Name: _______________________________

Address: _____________________________

City, State, Zip:________________________

Phone Number (___)___________________

Fax(___)_____________________________

E-mail:______________________________

Comments: _________________________________________

___________________________________________________

___________________________________________________

 

US-CHINA REVIEW (Our national journal) is included in your annual membership dues.

______ Individual $ 25.00

______ Family $ 40.00

______ Senior $ 20.00

______ Student $ 10.00

______ Sponsor $ 50.00 or more

Contribution $ ________ (tax deductible)

 

Make checks payable to : USCPFA

Detach this form and mail your application with payment to:

Lorraine Okeson
10 Watervliet Ave
Cohoes, NY 12047