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Membership Enrollment Form

 
First Name:
Last Name:
Title: Organization:
Address:
City:
State:
Zip Code:
Telephone:
Fax:
E-mail:
Congressional District:
Don't know your congressional district? Find out at www.house.gov

Please select your membership type and fee level in the field below.  Options include:

     AIDS Housing Policy Council - $1,000

          Organizational Partner (based on organizational budget size)*

      $750 (Budget Size:  $1 million - $5 million)

      $500 (Budget Size:  $750,000 - $1 million)

      $300 (Budget Size: Under $750,000)

    Associate - $250

    Individual - $100

    AIDS Housing Consumer - Fee Waived; Donations encouraged

     
* Operating Budget does not include capital or pass-through
 

 

 
 
 
 

727 15th Street, 6th Floor

Washington, DC 20005

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