Universal membership application form
National Adult Council LULAC Membership Application Form
League of United Latin American Citizens
® Est. 1929
(Liga Ciudadanos Latino Americanos Unidos)
Universal membership application form
(Forma universal para aplicar para membrecia.)
National Office Adult Council Application for Membership
(Aplicacion de oficina Nacional para Miembresia de Adultos)
LULAC - TEXAS - DISTRICT XXI
IN CARE OF
Box 150001
Arlington, TX 76015
(817) 467-3087
Lico@LicoReyes.com or Lico@Eaze.net
Council No. __________________________________________ League of the United Latin American Citizens.
(Consilio) - City, State - (Ciudad, Estado) (Liga de Ciudadanos Latino Americanos Unidos)
I, the undersigned, herby most respectfully make application to become a member of your league and hereby state that I have read and wholeheartedly subscribe to you aims and purposes, your code, and your constitution. I have complied with the instructions herein contained and on my honor, I certify to the correctness of the answers below :
this ____________ Day of Month_____________________________ ,__________AD.
(Dia) (Mes) (AD)
PRINT Full Name: ____________________________________________________________________________
Nombre Completo En Molde
Complete Home Address:_________________________________________________________________________
Domicilio Completo
____________________________________ __________________ ____________________
City (Ciudad) State (Estado) ZIP-Code (Codigo Postal)
Phone: Home ( )______________________ Work ( ) _________________________Cell ( )_________________
Telefono Casa Trabajo Cellular
E-Mail: _________________________________________________________________________
Domicilio Internet
Occupation: _________________________________________________________________________
Hobbies: _________________________________________________________________________
Pasatiempos
Reason for joining LULAC: _______________________________________________________________
Rason por querer pertenecer a LULAC
Member of other Clubs/Organizations: ______________________________________________________
Miembresia en Otras Organizaciones
Signature of Applicant: __________________________________________________________________
Firma
We, the undersigned members in good standing of the LULAC organization certify that we are personally aquainted with the applicant and know, to the best of our knowledge and belief, that he/she is the person of moral character and worthy of being a member of this league and we further certify that the answers to the foregoing application are true and correct.
Signature of Member _________________________ Signature of Member _________________________
Annual Membership Fee - (Quota anual por membrecia) $ 25.00 (USA): ___________________________________________________
(Coumcil fee may vary - Quota puede varear por Concilio)
LULAC Web Sites:
LULAC - Texas - District XXI - "Lulac International" (AKA Council #4779) www.LulacInternational.FreeHomePage.com
LULAC - TX- District XXI
http://www.lulacdistrict21.org/index.htm
LULAC NATIONAL
Send Your Application By E-mail or by Mail:
Our Address
Box 150001
Arlington, TX 76016
USA
My Phone Numbers
Work - (817) 467-3087
C -(817) 454-4716
