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Jac Conaway FOTEC Treasurer   

51 Tongorekill Rd.

Olivebridge, NY 12461-5507

ASSOCIATE

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Street: 

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FAMILY (same address):

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Country of Service Data:       

Eastern Caribbean  -  ________________________

Please circle one:          Volunteer         Staff

Years of Service:          _ _ _ _  -  _ _ _ _

Country of Service Data:       

Eastern Caribbean  -  ________________________

Please circle one:          Volunteer         Staff

Years of Service:          _ _ _ _  -  _ _ _ _

Join Now / Contribution:

Friends of the Eastern Caribbean

Mini Grant Contribution (Tax Deductible)

Other for ______________________

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 $________    1 Yr  $15

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 $________    Total     

Family

 $________    1 Yr   $22.50

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 $________      Total