Please complete the application below:
AFC MEMBERSHIP APPLICATION
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Advocates for Change Membership Application
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Applicant Information
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| Name: Today’s date: |
| E-mail: |
| Home Phone: |
Work Phone: |
Cell Phone: |
| Current address: |
| City: |
State: |
ZIP Code: |
Affected Person Information
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| Name: DOB: |
| DOC #: |
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| Facility: |
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| Address: |
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| City: |
State: |
ZIP Code: |
| Additional Information: |
Check one below
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TYPE OF MEMBERSHIP
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COST
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PLEASE CHECK HERE
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| Affected Person In Criminal Justice System |
8 Stamps per year |
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| Affected Person in Community |
$ 5.00 per year |
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| Membership Dues |
$20.00 per year |
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| Donations (fill in amount) |
_______________ |
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comments
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| ______I would like to Volunteer. (Your service is vitally needed. Please contact a board member to find where you can be the most help).* * * * * |
Please send payment to:
Advocates for Change
P.O. Box 351032
Westminster, CO 80035
To Contact us please call or email
Phone: 720-690-1725 * advocates4changeafc@yahoo.com
Web site: www.advocates4change.org
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Hi! Please send me an application, thanks!
Hi Kerry, we’ll send you an application to the email you provided but it is now available above.
Mark, We received your application. Thank you. We will be sending you our latest newsletter.