Guatemala Adoptive Families Network -- Membership Form Ready to join? Just print this form, fill it out, and mail it to us at the address shown. Don't forget to include your annual dues of $20 per family for 2005, and your contribution for Material Aid. Name _______________________________________________________________ Address ____________________________________________________________ ____________________________________________________________ City, State/Province _______________________________________________ Postal Code, Country _______________________________________________ Telephone __________________________________________________________ EMail ______________________________________________________________ Please list the name (optional), age, and the year the child joined your family, for each of your children adopted from Guatemala (if applicable): _______________________________________________________________ _______________________________________________________________ Please check any committee(s) you can work on to help carry out our volunteer, grassroots efforts: ___ Material Assistance ___ Publications and Media ___ Adoption Information ___ Membership and Administration ___ Public Relations ___ Fundraising and Development Membership type: ___ Standard -- please check a category below: ___ Family with child(ren) adopted from Guatemala ___ Family awaiting a Guatemalan child ___ Extended family member of one of the above ___ Guatemalan adoptee ___ Associate (adoption professionals and others) Amounts enclosed: 2005 dues ($20 US/family) _______________ Contribution for Material Aid* _______________ Additional contribution for Guatemala _______________ Adoptive Families Network operations Total enclosed _______________ Complete this form and mail with your check or money order to: Guatemala Adoptive Families Network, P.O.Box 176, Watertown, MA 02471, USA. Contributions are not tax-deductible at this time (we're working on it). * 100% of Material Aid contributions will go to material aid projects. The Network is dues-supported and does not take any administrative or other fees from material aid contributions.