CAFA              
CAFA P.O.Box 898, Cary, NC 27512
www.cafanc.org

华联会员申请表
CAFA Membership Application Form
(This form is available at http://www.cafanc.org/membership/register.html)

(Fields marked * are required)
*Publish my name in CAFA Directory:
Yes - publish my entry and will select what to be published below. No - don't publish my entry at all in CAFA Directory.
Applicant Information
申请人信息
Co-applicant Information [If family]
配偶信息
*Chinese Name:
中文姓名:
(If you don't have a Chinese input software, please use inputking.com to enter your Chinese name and copy it here)
Chinese Name:
中文姓名:
*English Name
First:
Last:
English Name
First:
Last:
*Email:
电子邮件:
Publish it in CAFA Directory? Yes No
Subscribe official CAFA announcements? Yes No
Subscribe public CAFA mailing list? Yes No
Email:
电子信箱:
Publish it in CAFA Directory? Yes No
Subscribe official CAFA announcements? Yes No
Subscribe public CAFA mailing list? Yes No
*Gender 性别: Male(男)  Female(女)
*Home Phone:
家庭电话:
() - Publish it in CAFA Directory? Yes No
   Work Phone:
工作电话:
() -   Publish it in CAFA Directory? Yes No
 Mobile Phone:
手机电话:
() - Publish it in CAFA Directory? Yes No
*Home Address 家庭住址:
Street:
City:
State:
ZIP:
Publish it in CAFA Directory? Yes No
*Select a CAFA Membership Type(华联会费):
Family membership for one year(家庭一年): $15 Family membership for two years(家庭两年): $30
Single membership for one year(单身一年): $12 Single membership for two years(单身两年): $24
*Select a payment method:
Pay by credit card
through PayPal
Will send a check
by mail

Note 1:
  You don't need to have an existing account with Google Checkout or PayPal to use your credit card - you can sign up one instantly. When you pay by Google Checkout or PayPal, your credit card information is stored securely in Google Payment Corporation or PayPal and will not share with anyone else, including CAFA.

Note 2:
  If you will pay by a check, please make your check payable to CAFA and mail the check along with this application form to
(支票收款人请写 CAFA, 请将会费支票寄至):

CAFA, P.O. Box 898, Cary, NC 27512

Comments:
    Please write your comments or special instructions below.
      
For questions, please contact membership@cafanc.org