MIAG Membership Application Form - 2019
Membership Status *
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Please check off the appropriate membership category: *
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Please fill out the following information:
Name (Individual/Group/Organization):
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Address:
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City: *
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Postal Code:
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Telephone:
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Fax:
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E-mail:
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Web site:
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Only for Groups, Organizations or Businesses
Executive Director:
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Contact Person: *
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Position:
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Address and City (If different than above):
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Postal Code ( If different than above):
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Telephone:
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E-mail:
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Fax:
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Please be advised that the membership year is January to December.
We support MIAG mission statement, which is to enhance the capacity of individuals and families from different ethno-cultural communities through empowerment, innovation, and well-being based programs and services.
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