SOUTHEAST CONNECTICUT WORLD AFFAIRS COUNCIL Dedicated to educating and engaging Americans on global issues Membership Form To join SECWAC for the 2015-2016 Speaker Series Season, please print, complete and mail this form to: SECWAC 914 Hartford Turnpike Suite 206 Waterford, CT 06385 I/We would like to be members of the Council, and enclosed is a check payable to SECWAC for $____________ ($75 is the annual fee for each member) (Please print all information clearly) Name of each member: ____________________________________________________ ____________________________________________________ Address: ____________________________________________ City:_______________________________________________ State:_________________________Zip:__________________ Email:_____________________________________________ Phone:____________________________________________ For additional information: Call: 860-912-5718 Email US at: info@SECWAC.org A Proud Member of:
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