Join!

Application for Membership

By virtue of your visit to this site you are demonstrating interest in Haiti and its' culture. Why not join us, at NOAH, in championing the cause of Haiti? For pennies a day, you, too, could make a difference. Thank you for your interest in Haiti! Our membership form is attached.

Please check one:

Corporate - Lifetime

$10,000

Corporate - Annual

$2,500

Nonprofit - Lifetime

$5,000

Nonprofit - Annual

$500

Individual - Lifetime

$2,000

Professional - Annual

$250

Individual - Annual

$75

Friend - Annual

$25

Student - Annual

$10

Please fill in your contact information:

First name:

Last name:

Address:

City:

State:

Zip:

Phone:

Fax:

Professional Affiliation:

Other Haitian Group Affiliations:

Comments:

Committee Membership:

Yes, I want to assist NOAH in "Restoring democracy for Haitians in the Unithed States and Abroad," and "Rebuilding Haiti for a Brighter Tomorrow" by volunteering my services. I wish to serve on the following committees:

Immigration	Health and welfare	Fund Development
Legal	Education	Newsletter
Research	Grassroots	Other
Membership

All rights reserved 2000
1400 East West Highway Suite G, Silver Spring, MD 20910
Tel: 1-800-355-0204 Fax: 301-585-5395
NOAH e-mail: jbaptiste@noahhaiti.org
Site design by EJZDesign
Upcoming 2001 events