United States Air Force Academy Parents Association of Nebraska

AFA Parents Association of Nebraska
2011 – 2012 Annual Registration Form

For a printable version of this form click here.

~ Please complete if already a member so we may update our records ~

	Cadet Information
Full Name:			P.O. Box #:
Male:	Female:	Graduation Year:	Squadron Number:
Date of Birth:		Attending: Academy or Prep School
Academy Email Address:
	Father's Information
Last Name:	First Name:
Mailing Address:
City:	State: Zip:
Home Phone:	Cell Phone: Work Phone:
Email Address:
	Mother's Information
Last Name:	First Name:
	( Check here if both parents share the same mailing information)
Mailing Address:
City:	State: Zip:
Home Phone:	Cell Phone: Work Phone:
Email Address:

	Annual Dues and Information
	I would like to make an online payment of $30 for the 2011-2012 Membership year. (AFTER SUBMITTING THIS FORM PLEASE CLICK ON THE MAKE PAYMENT BUTTON)
	I would like to make an online payment for all four years for $100 (savings of $20). (AFTER SUBMITTING THIS FORM PLEASE CLICK ON THE MAKE PAYMENT BUTTON)
	I would like to send a check for payment of $30 for the 2011-2012 Membership year. (AFTER SUBMITTING THIS FORM PLEASE SEND A CHECK FOR $30 TO THE PAYMENTS ADDRESS LISTED ON THE NEXT PAGE)
	I would like to send a check for payment for all four years for $100 (savings of $20). (AFTER SUBMITTING THIS FORM PLEASE SEND A CHECK FOR $100 TO THE PAYMENTS ADDRESS LISTED ON THE NEXT PAGE)
	I have already paid membership for all four years.
	I do not wish to join at this time.
	Please share reason for not continuing to help us improve services to our membership.

	NOTE: If your cadet leaves USAFA you will receive a pro-rated refund if you pay dues upfront for all 4-years.

	Value Added Member Benefits and AFAPAN Opportunities
	Your AFAPAN Executive Committee encourages you to give thought and consideration to being active members in our organization. As a non–profit organization it is imperative that our membership are active participants. The work we do throughout the year is for the benefit of our Nebraska cadets. The continued success of our organization to carry out our mission of networking, educating and charitable giving in support of the AFA community is largely dependant on an active membership. Please choose below how you would consider being involved.

	Birthday Cards / Graduation Gifts (sent to current AFAPAN member cadets)
	Club Website – Work with Webmaster to keep AFAPAN up-to-date (on-going updates)
	Parents’ Weekend Tailgate/Meeting – September 2011
	Fall Meeting/Finals Packages – November 2011
	All Academy Ball – December 2011 (Please plan on attending … Army is hosting in 2011)
	Spring Meeting – March 2012
	Appointee Luncheon/Meeting – June 2012