La Raza Network

P.O. Box 162027

Sacramento, CA 95816

http://LaRazaNetwork.org

 

2008 MEMBERSHIP APPLICATION

 

Mission Statement:

 

"La Raza Network shall be an advocate for all Latinos and will network with other organizations, share issues, and promote working with others to achieve goals as defined by the assembly."

 

Name: ______________________________________________________________

 

Address: ____________________________City: ________________Zip: ________

 

Message Phone: _______________________ Cell Phone: ______________________

 

Email Address: ________________________________________________________

 

Representing Organization (if any):

_________________________________________________

Organization Address (if known): ______________________________________________________

 

Please indicate membership level:

______ Single Annual Membership $20

______ Organization Annual Membership $50

______ Associate Annual Membership $10 (no vote)

______ Student Annual Membership $5 (no vote)

 

-- Instructions: Please print application, fill out and mail to address above and enclose check made payable to: La Raza Network, or bring completed application and check to next LRN meeting.--