Membership Application Name(s) _____________________________ Address _____________________________ City_________________________ Telephone (_____) _____________________ Cell: ___________________ Fax:__________ Work Phone __________________________ E-mail _____________________________ County_______________________________ Please check the membership level you want: Basic Individual, 15000frw per year Married Couple, 24000frw per year Sustaining(Cause to continue or be prolonged for an extended period or without interruption) 18000frw per month 30000frw per month 60000frw per month _____frw per month Life 600000frw one time Charter 3000000frw one time 150000frw per month for 20 months Gift for Education Fund: _______Frw The Education Fund help us to produce the quality Education Gift for Faith Fund:__________frw The faith Fund help us to fillfull our vision Make checks payable to: UDR impezamihigo party Annual Subscription Statement 1. I am eligible to vote in the state in which I reside and am not a member of any other political party. 2. I agree with and will support the purpose of the UDR Impezamihigo as expressed in its Vision, & Principles documents. (These can be obtained by calling 0785810038 or by visiting our page on facebook(UDR impeza mihigo) 4. I agree to operate according to the policies and procedures set forth in the party Constitution and Bylaws. 5. I understand that subscribers may voluntarily withdraw at any time from this association without a refund of any membership donations. 6. I agree that men of every nation, tongue and race are of one blood . 8. I agree to pay an annual subscription fees. I (we) meet the above requirements. Membership Year: _______ Signature(s): Date _________________ For Office Use Only Date Received ______________ Check # or Cash ______________ UDR Impezamihigo Party
Posted on: Tue, 10 Sep 2013 11:50:51 +0000
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