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OCA Membership Form
Dedicated to advancing the social, political and economic well-being of Asian Pacific Americans
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
M.I.
Your answer
Last Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Mailing Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Telephone Number
*
Your answer
Alma Mater (Optional)
Your answer
Marital Status
*
Single
Married
(If single, answer "N/A") ...................................................................................................................................................... If married, name of spouse/partner:
*
Your answer
OCA Membership Categories & Fees
*
Youth & Students | High School & University Level - $10
Individual Adult | 18 years or older - $40
Senior Citizens | 65 years or older - $20
Family | includes 2 adults + 2 children (under the age of 18) - $50
Individual Adult Lifetime | 18 years or older - $1,000
Family Lifetime | includes 2 adults + 2 children (under the age of 18) - $1,500
If you have selected family, please tell us the first and last name, their relationship with you, and their date of birth.
Your answer
Are you willing to serve on the OCA Greater Phoenix Chapter Board?
*
Yes
No
Please list any activities and/or events you would like to see OCA Greater Phoenix Chapter sponsor:
Your answer
A copy of your responses will be emailed to the address you provided.
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