Chinese-American Association of Tampa Bay

P. O. Box 48303, Tampa, FL 33646, USA

caat-board@googlegroups.com

Last Name	First Name	Chinese Name

Address	City	State	Zip

Hobbies (i.e. fishing, cooking, dance, etc.)		Phone #	
				
Membership Status		Clubs/Interest		
___New	___Social Club	___Performance Club	
___Renewal	___Business/Professional Club	___Youth Club	
	___ Other :__________________________________________	
				
Family Members Name	Relationship	Chinese Name	Email	

I/We wish to apply/renew our membership and make a contribution of

___$5 for Student/Associate Membership

___$10 for Family Membership

___$50 to $99 for Contributor Membership

___$100 or more for Corporate Membership

_____________________________________

Signature	Date

Please sign and mail this form with payment to the address above. Thank you and welcome to CAAT.