ASPAC-NGO Membership Application Form

August 8, 2008
Name : * Sirname : *
Birthdate (D/M/Y) :  

Age :  Occupation : *
Position :  Organization : *
Mailing Address : *
City/State : * Postal Code : *
Country :

Tel : * Fax :
E-Mail Address : *
Membership Category (Choose One Only)*
        I, hereby, acknowledge and am pleased to act in compliance with the objectives and missions of ASPAC-NGO stipulated in this brochure and also pledge not to do anything to bring about unfavorable reputation to the Organization.

        Enclosed with the application form is the registration fee and annual membership fee in US dollars payable to ASPAC-NGO Secretariat of which the mailing and e-mail addresses appeared in the cover of this brochure.

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