LIBA-D Membership Form

LIBA-D COMMITTEE, INC.
Let's Involve Beautiful America in Developing Coalescence
"A Multiracial, Bi-County, Human Rights Organization To Unify All People"

MEMBERSHIP


	Please fill out, print, and mail this application. Make checks or money orders payable to: LIBA-D COMMITTEE, INC. P.O. BOx 491, Commack, NY 11725

Title	First Name*	Last Name*

Company Name

Address*

City*	State*	Zip/Postal Code*

Phone Number (home)	Phone Number (business)

E-mail*

*These items must be filled out.

Students/Sr. Citizens $30.00 yearly

Individuals $50.00 yearly.

NFP Organizations $100.00 yearly.

Businesses $200.00 yearly.

Patrons $500.00 yearly.

Lifetime $1000.00

Other : $ (enter amount)

Free gift with each membership signup.

Member Benefits:

1. Membership Card
2. 10% discount on all LIBA-D Committee, Inc, & Jelly Bean Theatre Co. merchandise
3. Complimentary invitation to all LIBA-D Committee, Inc events
(Fundraising events not included)
4. Posting a Resume/Curriculum Vitae Service on our website

Have Questions?