| Sunflower Community Action One-Year Membership Form: | ||
| ___ $25 Individual | ___ $35 Family (2 or more) | ___ $50 Organization / Small Business |
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Name: ________________________________________ |
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Organization / Small Business Name: ________________________________________ |
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Address: ________________________________________ ________________________________________ ________________________________________ |
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Phone: ________________________________________ |
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Sunflower Chapter: |
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___ Northeast Wichita ___ Southwest Kansas Chapter |
___ Hispanos Unidos ___ Youth Action Group |
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Mail Completed Form with Check or Money Order to: Sunflower Community Action |
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