Colombian American Association

Type of Membership:

Supporting $2.000.00
Corporate $650.00
Overseas Corporate $250.00
Individual $250.00

Name of Applicant:
Title:
Name of Company:
Address:
City:
State:
ZipCode:
Country:
Telephone:
Fax number:
E-Mail:
WebPage

PAYMENT:

By check

By credit card

Type

American Express

Mastercard

Visa

Please provide the following account information:

Name

Card #

Exp. Date

Applicable for Supporting and Corporate Members: Please provide a list of colleagues (including their address and phone/fax/E-mail numbers) who would like to receive invitations to events.

Colombian American Association, Inc.
30 Vesey Street, Suite 506, New York, NY 10007
Tel: (212)233-7776 Fax: (212)233-7779
E-mail: andean@nyct.net

Founded in 1927