AJE Foundation in Haiti Since 2004

Membership Form

 

AJE FOUNDATION

 

 

 

 

 

MEMBER INFORMATION

 

 

 

 

Last Name:__________________________             First Name:_____________  M.I________

 

Email Address:________________________________________________________________

 

Home Phone:_____________________________   Work Phone:__________________ ______

 

Best Time To Call:______________________________________________

 

MAILING ADDRESS

 

Address:______________________________________________________________________

 

City:_______________________________  State:_______________        Zip Code__________

 

 

OTHER INFORMATION

 

Project of Interest:_____________________________________________________________

 

 

 

 

 

 

 

Choose Time:___________   Date:_____Amount of Project::___________________________

 

 

 





Choose Area

 

North____________  South____________  Central___________ Other Places_____________

 

 _________________________________________            _________________________________________
 Member                                                                         Witness



_________________________________________            __________________________________________
Members of AJE Foundation                                        Members of AJE Foundation

Website Builder