AIITCO MEMBERSHIP FORM

AMERICAN INDIAN INTER-TRIBAL CULTURAL ORGANIZATION, INC

TWINBROOK STATION, P.O. BOX 775, ROCKVILLE, MD 20848

First Name:   MI  Last Name  

Address  City   State  

ZipCode     Phone: Home   Work Cell

 Email 1

Would you like the 'Rattle and Drum by e-mail or a paper copy ?   EMAIL     PAPER  

Type of Membership 

  Annual Dues: $14 - Individual (18 and over)      $18 - Family (includes children 17 and under)

ANNUAL MEMBERSHIP IS DUE EACH YEAR IN JANUARY. 

You can also purchase a Membership gift for a friend.  Just put on the check or form that it is a membership gift and please provide a name and address so the new members can get their newsletter.

Download, print and mail form along with membership dues to: AIITCO, Twinbrook Station P.O. Box 775, Rockville, Maryland 20848. 

      Signature: