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July 31, 2010
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The following information will be maintained in complete confidentiality and it is protected by Law.

I hereby request the INTERNATIONAL IMMIGRANTS FOUNDATION (IIF) to accept me as a contributing member. I have complete knowledge of the Foundation's purposes and benefits, I fully accept by submitting the application.

   1- Information about the Applicant
Have you been a Member of the International Immigrants Foundation?
  Applicant   
Prefix
Full Name
Date of Birth 19
Email Address
Country of Birth
Cultural Group
Sex
Civil Status
  Spouse   
Prefix
First Name
Last Name
Middle Initial
Date of Birth 19
Country of Birth
Sex

 

   2- Postal Address
In care of
Address
City
State
Zip Code
Country

 

   3 - Phones Numbers
Home
Work
Home Fax
Work Fax
Beeper
Cellular

 

   4 - Education
Highest level completed
Languages that you speak and read
Profession
Actual Position
Annual Salary $


   5 - How did you learn about our Foundation?
It is very important to recognize who referred you.  Thank you for your cooperation.

Through   

Please state by whom

   6 - Submit this form

By submitting this form, I, the applicant, hereby declare that all the above information are nothing else but truth.
 

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© Copyright 2001 International Immigrants Foundation
1435 Broadway, 2nd Fl. New York, NY 10018 USA
Tel: (212) 302-2222 - Fax: (212) 221-7206
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