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? No Yes   Applicant    Prefix Mr. Ms. Mrs. Hon. Full Name Date of Birth Jan. Feb. Mar. Apr. May Jun. Jul. Aug. Oct. Nov. Dec. 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 19 80 79 78 77 76 75 74 73 72 71 70 69 68 67 66 65 64 63 62 61 60 59 58 57 56 55 54 53 52 51 50 49 48 47 46 45 44 43 42 41 40 39 38 37 36 35 34 33 32 31 30 Email Address Country of Birth Cultural Group Sex Female Male Civil Status Single Married Divorced Widow   Spouse    Prefix Mr. Ms. Mrs. Hon. First Name Last Name Middle Initial Date of Birth Jan. Feb. Mar. Apr. May Jun. Jul. Aug. Oct. Nov. Dec. 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 19 80 79 78 77 76 75 74 73 72 71 70 69 68 67 66 65 64 63 62 61 60 59 58 57 56 55 54 53 52 51 50 49 48 47 46 45 44 43 42 41 40 39 38 37 36 35 34 33 32 31 30 Country of Birth Sex Female Male      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 Elemental High School College/University 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  a Recommendation a Member an event the Media an organization   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.