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MEMBERSHIP APPLICATION/DIRECTORY
INFORMATION SHEET
Name
Credentials
Organization/Business Affiliation
Title
Business Address
City State
Zip Work Phone
Home Phone    
Email Address
Areas of expertise/interest(s)
Skills: (Please check all that apply)
Bilingual/Spanish   Grant Writing
Public Speaking   Program Evaluation
Meeting Facilitation   Professional Development
Web-site Development/Maintenance   Other
Budgeting/Financial      
   
AFAHC Membership Status: (Only paid members will be provided with a Membership Directory/Email list)
Paid Member   Board Member
Non-paid Member   Officer
Student Member      
   
What year did you join AFAHC?
How did you hear about AFAHC?
   
On which AFAHC committee would you be interested in serving? (Committees meet as needed, by phone, or by email)
Membership: plan membership recruitment activities and events, update Membership Directory
Education/Program: plan educational programs for membership meetings. Oversee and coordinate AFAHC collaboration with other organizational programs/events
Fundraising: develop fundraising opportunities and prepare grant proposals
Research: oversee and coordinate support and participation in research projects
   
Are you interested in: (check all that apply)
Staffing an exhibit at community events
Speakers Bureau
Serving as a media spokesperson for AFAHC
Representing AFAHC for advocacy opportunities
Other
   
With what other organizations are you affiliated?
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