Catégories d`Adhésion / Membership Categories Total

________________________________
Nom / Family Name
Cotisation de septembre à septembre /
Membership from September to September
(Registration deadline to be part of the
directory is October 31)
________________________________
Adresse /Address
Catégories d’Adhésion /
Membership Categories
Individual Sponsor ....................... $275.00 □
Corporate - Level 1 .......................$175.00 □
Includes membership for two employees plus
your corporate logo displayed on the Alliance
Website
Corporate - Level 2 ......................$275.00 □
Includes membership for two employees plus
your corporate logo displayed on the Alliance
web site and on emails in the sponsor area.
Corporate - Level 3 ....................... $500.00 □
Includes membership for two employees plus
your corporate logo displayed on the Alliance
web site, on emails in the sponsor area, and on
a sponsor recognition poster at Alliance events.
We wish to make an
additional donation
Total:
________________________________
Prénom / First Name
________
__________
Note:
Les dons donnent lieu à des
abattements d'impots /
Donations are tax deductible
□
________________________________
Ville, Etat / City, State
_______________________________
Code postal / Zip code
( ____ ) _____________
Téléphone / Telephone
________________________________
Courriel / E-mail
________________________________
2nd Courriel / second e-mail
□
I do not wish my name to appear in
the yearly directory
For new members only, how did you
hear about the Alliance Française ?
___________________________________
_
Règlement par chèque à l’ordre de :
Make check payable to:
Alliance Française de Cincinnati
A envoyer à / Send to:
Alliance Française de Cincinnati
3500 Columbia Parkway
Cincinnati, OH 45226