BIRMINGHAM COMMITTEE ON FOREIGN RELATIONS
1400 Park Place Tower
2001 Park Place North
Birmingham, AL 35203


TO: Chairman and Board of Directors

Date:

SUBJECT: Application for Membership

 

PLEASE CHECK ONE:

_____I would like to nominate the following as a member of the Birmingham Committee on Foreign Relations:

_____I would like to be considered to become a member of the Birmingham Committee on Foreign Relations

 

Name:

_______________________________________________

 

Home Address:

_______________________________________________

_______________________________________________

 

Home Telephone:

_______________________________________________


Office Address:

_______________________________________________

_______________________________________________

 

Work Telephone:

_______________________________________________

 

Fax:

_______________________________________________


Business or Occupation (with any relevant reference to international activities)

_______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________

 

Other comments:

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________


Nominee/Applicant is also known to the following members of the Birmingham Committee (not mandatory):


_____________________________ _______________________________


_____________________________ _______________________________


_____________________________ _______________________________


_____________________________ _______________________________


Signed: _________________________________

 

Please return to:

Regina P. Ash
Birmingham Committee on Foreign Relations
1400 Park Place Tower
2001 Park Place North
Birmingham, AL 35203