The American Committee for the Reunification of the Parthenon Sculptures, Inc.

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APPLICATION FOR MEMBERSHIP

First Name*

Last Name

Street Address

City

State

Zip

Country

Your Telephone (Include area codes)

Main Contact Phone *

Alternate Contact Phone

Your E-mail*

Business or Profession

AVAILABILITY TO ASSIST THE COMMITTEE IN
(please check as appropriate):

	Public relations
	Writing newsletter
	Web page design/maintenance
	Organizing events
	Recruiting members
	Contacting persons in government
	Fundraising
	Other (please specify):

Annual Memberships (please check as appropriate):

	Regular ($25.00)
	Student ($15.00)
	Supporter ($50.00)
	Business ($100.00)
	Benefactor ($250.00)
	Sponsor ($500.00)
	Please accept my additional donation in the amount of:
	$

Please make out check payable to the AMERICAN COMMITTEE FOR THE REUNIFICATION OF THE PARTHENON SCULPTURES, INC. or ACRPS, Inc.
and mail it to:

American Committee for the Parthenon
7850 NW 146th Street, Suite 501
Miami Lakes, FL 33016