Armenian Educational Foundation, Inc.

600 West Broadway, Suite 130, Glendale, CA 91204 Phone (818) 242-4154 Fax (818) 242-4913

AEF MEMBERSHIP APPLICATION

NAME: ______________________________________________________

ADDRESS: ___________________________________________________

CITY, STATE, ZIP: ____________________________________________

TELEPHONE-HOME: __________________ WORK:________________

FAX: ______________________ E-MAIL: _________________________

CURRENT AEF MEMBER SPONSORING THIS

APPLICATION: ______________________________________________

THE FOLLOWING INFORMATION IS OPTIONAL:

OCCUPATION: _______________________________________________

INTERESTS & HOBBIES: _____________________________________

_____________________________________________________________

CHILDREN: NAME: _____________________________ AGE: _______

NAME: _____________________________ AGE: _______

NAME: _____________________________ AGE: _______

Please sign and date below and enclose your tax-deductible annual membership dues of $500.

Signature ________________________________________ Date _________________