The African American Lupus
Foundations, Inc
612-822-0206 (fax) 612-822-0253
AALF, INC. Membership Application
Name
_____________________________________________________________________________
Organization
_______________________________________________________________________
Address
___________________________________________________________________________
Telephone (
)__________________________ Fax (
)___________________________________
Email:
________________________________________ Website:______________________________
Yes!
I’d like to become a member of THE African American Lupus Foundation!
Ujamaa (Corporate
Membership)
$1000
Imani (Sustaining Membership) $500
Kuumba (Special Interest
Groups) $500
Nia (Individuals) $25
Ujima (Community
Based Organizations and Coalitions) See Below
I certify that I remain committed
to, and will uphold the mission, goals, and objectives of the African American
Lupus Foundation, Inc.
I pledge to disclose all relationships
and associations with representatives of the to African American Lupus
Foundation, its parent companies, and subsidiaries.
I also pledge that none of my own
activities will conflict with efforts to carry out the mission of this
organization. If I am unable to adhere
to the terms of the African
American Lupus Foundation and by-laws I will notify the AALF, Inc leadership of
such conflicts and resign my membership at such time.
Signed
Date