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Please fill in the information below to enroll as a member, to make a tax deductible contribution or, to establish a memorial bequest.


Contact Information

Name:
Address:
City:
State:
Zip Code
Email: *Required
Company:
Phone:

      Please enroll me with the following Basic Membership:

College Student - ($15.00)
Individual - ($50.00
Family - ($75.00

      Please enroll me with the following Corporate Membership:

Diplomatic - ($150.00)
Ambassadorial - ($250.00)
Statesman - ($500.00)
Cabinet - ($1,000.00)
Presidential - ($2,500.00)

       I would like to make a tax deductible contribution

Amount I wish to contribute.

If other, please enter here.

I am interested in establishing a memorial bequest to Alaska World Affairs Council.

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