November Discount Form
American Adoption Congress November New Membership Application
Join AAC to commemorate National Adoption Awareness Month
(Rates discounted 20% during November ONLY)
Join AAC to commemorate National Adoption Awareness Month
(Rates discounted 20% during November ONLY)
We welcome your new membership in the AAC! Please check all of the following which apply
_________ Initial here(REQ) to state you have read and understand the AAC Code of Ethics:
Billing Address: If different from Above
AAC accepts Visa, Mastercard, Discover and American Express
Type of Membership: Discounted 20%
* 2 membership conference discounts
** 5 membership conference discounts
Must be POSTMARKED by November 30
Mail to: AAC Membership c/o Susan Friel-Williams
2215 SE 3rd St . Cape Coral, FL 33990-1424
Adoptee | Foster Family | ||
Adoptive Parent | Foster Family Member | ||
Adoptive Relative | Extended adoptive/foster family | ||
Birth/First Parent | Professional | ||
Birth Relative | Organization | ||
Foster Child | Support Group |
_________ Initial here(REQ) to state you have read and understand the AAC Code of Ethics:
Name: |
Organization/Agency: |
Position: |
Address: |
City: | State: | Zip/Postal Code: |
Phone: (H) or (C) | Email: |
Billing Address: If different from Above
Name: |
Address: |
City: | State: | Zip/Postal Code: |
AAC accepts Visa, Mastercard, Discover and American Express
Card# | Exp Date |
CSV# (Back or Front |
Full Name on card: |
Referred by: |
Type of Membership: Discounted 20%
Check One |
Membership Plan | Regular Rate | Discount Rate |
Individual | $50.00 | $40.00 | |
Student (copy of student ID) Senior (62+ copy ID or License Disabled or Veteran |
$40.00 | $32.00 | |
Household* Search Group* |
$60.00 | $48.00 | |
Organization** Agency** |
$160.00 | $128.00 |
* 2 membership conference discounts
** 5 membership conference discounts
Must be POSTMARKED by November 30
Mail to: AAC Membership c/o Susan Friel-Williams
2215 SE 3rd St . Cape Coral, FL 33990-1424