Friends of Niger Home Page /  Friends of Niger Membership Form  [ PDF Version ]

Calendar orders: please fill our your information and check the calendar box on the order form below

Name(s) _________________________________ Date: _______________________________
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 _______________________________________________
_______________________________________________________________________________

Membership Dues & Contributions help fund FON Activities - including The Camel
Express, the FON website, Archives, and Projects such as Those Listed Below.

The Friends of Niger is a tax-exempt organization under section 501(c)(3) of the
Internal Revenue Code. Contributions to Friends of Niger are fully tax deductible.

*******************************************************************************

Please Check Appropriate Boxes
[ ] Enclosed is $20 for an Individual Membership in FON
[ ] $55 to cover Individual Membership in both FON & NPCA
[ ] Enclosed is $35 for a Family Membership (2 Members at One Address)
[ ] I am a current Niger PCV, entitled to Free Membership
[ ] I am a New RPCV, entitled to a 1-Year Free Membership

New and renewing members are entitied to one FREE copy of Brother from Niger
    Format Choice:  DVD ____    VHS ____    No Thanks ____

[ ] 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 FON's Young Girls' Scholarship Program activities
    with a Contribution of ........................................... ________
    
[ ] I want to support FON's Microcredit in Niger activities
    with a Contribution of ........................................... ________
    
[ ] I want to support FON's Appropriate Technology activities
    with a Contribution of ........................................... ________

[ ] I want to support FON's Youth Education activities
    with a Contribution of ........................................... ________

[ ] I want to support the FON Chewable Vitamin Campaign
    with a Contribution of ........................................... ________

[ ] Please send _____ 2008 International Calendars
    $12 each (shipping included)
    2 or more for $10 each if going to same address .................. ________

[ ] Please send _____ copies of Brother from Niger/DVD
    Format Choice:  DVD ____    VHS ____
    at $20 (2 for $35) (Shipping Included) ........................... ________

[ ] Please send _____ Friends of Niger T-Shirts
    at $18 each (Shipping Included) .................................. ________
    T-Shirt Sizes: S ____  M ____  L ____  XL ____

TOTAL AMOUNT ENCLOSED ................................................ ________

*******************************************************************************

Make Check or Money Order Payable to Friends of Niger and mail to:
 P. O. Box 5823, Washington, D. C. 20016-9998
Please complete and enclose this membership form.

FON Participation Menu
Indicate your interest with a check mark, or add something new in the space below.
[ ] Will help set up a local FON group
[ ] Would participate in a local FON group
[ ] Will be local FON contact person
[ ] Will be FON contact person for potential PCVs to Niger
Other: _________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________