Membership Form

I (We) want to promote Italian Language and culture in Washington and request membership in the Dante Alighieri Society of Washington. Enclosed is my (our) check in full payment of annual membership dues ($30.00 for individual, $40.00 for a family).

__________   New Membership

__________    Membership Renewal

Name(s):

Address:

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Telephone:   Area Code (_______)______________________

Email:  _______________________________________

Amount Enclosed

Membership Amount:

Contribution:

Total Enclosed:

Contribution Categories (For recognition stars)

Bronzo (bronze):
Argento (silver):
Oro (gold):
Platino (platinum)

Up to $25
$26 - $50
$51 - $100
Over $100

Please return completed membership application with check to:

Dante Alighieri Society of Washington
PMB #1244
1122 East Pike Street
Seattle, WA   98122