MEMBERSHIP FORM

MEMBERSHIP FORM

Adoptive and Foster Parent Association of Georgia

Print out and fill in...then mail to address

Name(s) ______________________________________________________________________

Address ______________________________________

County ______________________________________

City _________________________________________ State _________ Zip ____________

Telephone (____)________________

Occupation & Company __________________________________________________________

Position (Adoptive Parent, Foster Parent, DFCS Worker, Other): _________________________

Would you be interested in serving on a committee? Yes __________ No __________

The membership fee is $7.50 per person or $15.00 per family. Membership Year Jan. 1 - Dec. 31.

Make checks payable to AFPAG. Mail to: Terri Mitchell

2695 Dellinger Drive

Marietta, GA 30062