CCIP ZIMBABWE MEMBERSHIP FORM

First Name  Last Name 

Address       

City                 State  

Zip                

Email           

Individual/Family- $25.00 annually 

                                                                        Please type in yes

                             OR

Institution/Organization - $100.00 annually 

                                                                                      Please type in yes

Membership is open to any person, institution or organization interested in the purposes of CCIP-Zimbabwe, and who share the values of the same. CCIP-Zimbabwe members are allowed one (1) vote each at annual meetings called by the Board of Directors. Members will receive updates and newsletters, may be elected to the Board of Directors or its committees, and enjoy all membership privileges!

 

Please print this form. And mail it with payment (payable to CCIP-Zimbabwe) to

Janet Heyka, 1570 140 Road, Belleville, KS 66935

 

 

Thank you.