Arizona Association of the Deaf, Inc Senior Citizen Membership Form

Security Lock  Select in the boxes then click PayPal button.       Senior Citizen Membership: New    Renewal        Membership Due:                      Please Select ===> Month/Year/Rate SEPT 2011 $10.00 OCT 2011 $9.60 NOV 2011 $9.20 DEC 2011 $8.80 JAN 2012 $8.40 FEB 2012 $8.00 MAR 2012 $7.60 APR 2012 $7.20 MAY 2012 $6.80 JUN 2012 $6.40 JUL 2012 $6.00 AUG 2012 $5.60 SEPT 2012 $5.20 OCT 2012 $4.80 NOV 2012 $4.40 DEC 2012 $4.00 JAN 2013 $3.60 FEB 2013 $3.20 MAR 2013 $3.00 APR 2013 $2.60 MAY 2013 $2.20 JUN 2013 $1.80 JUL 2013 $1.40 AUG 2013 $1.00 ASDB Alumni? Yes PDSD Alumni? Yes       Contribution: $ (The AzAD is a 501(c)(3) organization; all contributions are tax-deductible to the extent allowed by the law.) Thank you for supporting AzAD!