Memberships

Name: Memberships
SKU: 22837
Availability: InStock

$0.00

Membership Form

(Note: Use separate form for Gift and Group Memberships)

(Dr.) (Mr.) (Mrs.) (Ms.)

First Name Middle (if any) Last Name

Email

Cell Phone

Day Phone

Evening Phone

Home Address

Residence number and Street City State ZIP Code

Work/Organization

Location

Street Address City State ZIP Code

Position or type of work

Check membership category below

Regular

Retired

Full-time student at

College/University Name

Note: All memberships include a subscription to OMEP’s publication, International Journal of Early Childhood (IJEC)

Optional Additional Contributions(Required)

Tax deductible contribution for our worthy programs and projects

Gwen Coe Scholarship Fund

Price(Required)

Total Due

Signature

Date

To pay by credit or debit please visit our website at https://omepusa.org
To pay by check, make check payable to OMEP-USA and send with this completed form to: Ebony Cray, OMEP-USA President, PO Box 830215, Stone Mountain, GA 30083

*OMEP-USNC/OMEP-USA is a not-for-profit organization. #52-6061431 Donations are tax-deductible as allowed by the Internal Revenue Code.

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Memberships

Membership Form

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