MANA Membership Application

Application Type *

NEW RENEWAL

First Name: *

Last Name: *

Name: *

First Name Last Name

Birthdate: *

Date

Title: *

Corporation/Organization: *

What is your area of expertise: *

Home Address (Street Address, City, State & Zip): *

Cell Phone Number: *

Area Code Phone Number

Personal Email: *

example@example.com

Work Address:

Work Phone:

Area Code Phone Number

Work Email:

example@example.com

Preferred method of contact: *

Home Work

What areas are you interested in getting involved? *

Mentoring HERMANITAS® in classroom Speaking Events Committee/Volunteer Attending Events Fundraising Committee Membership Committee Sponsorship

What motivated you to join MANA de North County? *

Networking Build my Business Empowering Latina Youth Giving Back to My Community All Things Latina Professional Development FUN! / Social Events

Comments: Anything else you'd like us to know?

SELECT YOUR MEMBERSHIP *

Regular Membership (Standard) ( $ 45.00 for each year )

Standard Membership

College Student Membership ( $ 15.00 for each year )

Eligibility: Current College Students and up to 12 months from graduation date

HERMANITAS® Mentor ( $ 35.00 for each year )

ONLY Active Mentors working with our Hermanitas Director

Senior Membership (Ages 60+) ( $ 35.00 for each year )

Senior Couple Membership (Ages 60+) ( $ 50.00 for each year )

BOARD OF DIRECTORS MEMBERSHIP ( $ 90.00 for each year )

ONLY Active Board Members

Corporate Membership ( $ 250.00 for each year )

Corporations, Small Business, Entrepreneurs and Organizations, including nonprofit partners.

Enter coupon