*on-line
forms are
coming.
Until then, please print, complete and mail this form to the address below on the right.
FRIENDS OF NIGER 2005 MEMBERSHIP & ORDER FORM
Name(s) _____________________________________________________________________________________
Address _____________________________________________________________________________________
City/State________________________ Phone (h) ______________________
Zip______________________________ Phone (w) ______________________
E- Mail Address ______________________________________________________________________________
Connection to Niger (RPCV, etc.) ________________________________________________________________
Dates in Niger_____________________ Location in Niger _______________
Program or Involvement in Niger ________________________________________________________________
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Membership Dues & Contributions Help Fund FON Activities - Including The Camel Express the FON website, the FON Archives, and Projects such as Those Listed Below
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Please Check Appropriate Boxes
[
] Enclosed is $20 for an Individual Membership in FON
[ ] $45 to cover Individual Membership in both FON & NPCA
[ ] Enclosed is $35 for a Family Membership (2 Members at One Address)
[ ] $67.50 to cover Family Membership in both FON & NPCA
[ ] I am a current Niger PCV, entitled to Free Membership
[ ] I am a New RPCV, entitled to a 1-Year Free Membership
[ ] Please send me a Copy of FON’s Bylaws (Members Only)
[ ] In Addition to my Membership, I have enclosed a General Contribution
of ____________
[ ] Instead of Joining FON at this time, I have enclosed a General Contribution
of ___________
[ ] I want to support the Mata Masu Dubara project with a Contribution
of _____________
[ ] I want to support the Oxcart Project with a Contribution of ____________
[ ] Please send _____ Friends of Niger T-Shirts at $18 each (Shipping
Included) __________
T-Shirt Sizes: S _____ M _____ L _____ XL _____
[ ] Please send _____ Year 2002 International Calendars at $12 each (Shipping
Included) __________
TOTAL AMOUNT ENCLOSED _____________
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Make
Check or Money Order Payable to Friends of Niger and mail to:
P.O. Box 5823, Washington, D.C. 20016-9998
(Please Enclose Membership Form)
FON Participaction Menu
Indicate your interest with a check mark. Or add something new at the bottom. Tell us how to reach you on the Friends of Niger 2001 Membership & Order Form (see above).
·
___ Will help set up local FON group
· ___ Would participate in local FON group
· ___ Will be local FON contact person
· ___ Trip back to Niger in 2002
· ___ Would be FON contact person for potential PCVs
to Niger
Other ____________________________________________________________________________
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