New IA Club Application/Solicitud de Membresía Internacional
Se requiere una tarifa de $35 para los clubes nuevos. New clubs must submit payment of $35 with their application.
Se requiere una tarifa de $35 para los clubes nuevos. New clubs must submit payment of $35 with their application. NOMBRE DEL DIRECTOR REGIONAL QUE SOLICITA NUEVA MEMBRESÍA AL NGC:(Select the Regional IA Chairman sending membership application to NGC)
*
México: Magda Cantú - magdaortega@prodigy.net.mx
Centroamérica: Cheryl Obediente - cheryl.obediente@gmail.com
Centroamérica: Cheryl Obediente - cheryl.obediente@gmail.com
Argentina/Chile/Ecuador/Perú: Susana Schiaffino - sschiaffino@yahoo.com
NOMBRE DEL CLUB AFILIADO / NAME OF CLUB:
*
PAÍS / COUNTRY:
*
NÚMERO DE ASOCIADOS / NUMBER OF CLUB MEMBERS:
*
NOMBRE DEL PRESIDENTE DEL CLUB / NAME OF CLUB PRESIDENT:
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First Name
Last Name
TIPO DE CLUB- TRADICIONAL O VIRTUALl / TRADITIONAL OR VIRTUAL CLUB:
*
TRADICIONAL
VIRTUAL
Application Fee
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Application Fee
$
35.00
Quantity
1
CORREO ELECTRÓNICO DEL PRESIDENTE DEL CLUB / CLUB PRESIDENT'S EMAIL ADDRESS:
*
example@example.com
CORREO ELECTRÓNICO PARA RECIBO DE PAGO / EMAIL FOR RECEIPT OF PAYMENT:
*
example@example.com
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