底特律区中国人协会会籍登记/更新表

Membership Form of The Chinese Association of Greater Detroit

Please fill in the form below to submit your information to CAGD. All red fields are mandatory. If you have trouble in submitting the electronic form, please print a hard copy of the form, fill in the necessary information, then mail the application form along with the check to the address below the form.

中文姓名

(Chinese name)
男 女

配偶中文姓名

(Spouse Chinese name)

英文姓名

(English name)
First Name: Last Name:

配偶英文姓名

(Spouse English name)
First Name: Last Name:

工作电话

(Work phone)

配偶工作电话

(Spouse work phone)

Email 地址

(Email address)

配偶Email 地址

(Spouse Email address)

家庭地址

(Home address)

住宅电话

(Home phone)

城市

(City)

住宅传真

(Home fax)

州

(State)

邮址编码

(Zip Code)

家庭成人数

(Number of Adult)
如果你想在会员通讯录上公布你的姓名，地址和电话，请在这打X。

To join CAGD, you may submit your membership application electronically here, but understanding a CAGD membership committee Chairman will follow this up with you via phone call regarding the Chinese spelling of your name and your life-time membership fee of $15/person or $20/family. Please send check to the following address. Thank you.

CAGD
P. O. Box 1343
Troy, MI 48099.