International Connections of Houston

14027 Memorial Drive #394 • Houston, TX- 77079 

 

www.internationalconnectionshouston.org

 

MEMBERSHIP FORM

Please use block print when completing this form.

 

New Membership                                   Renewal

 

First name	Last name

 

Country of origin	Citizenship

                                                                                            

Address (Street number and name)

 

City	State	Zip Code

 

Telephone number

 

E-mail address

 

Countries in which you have lived

 

Languages spoken

 

Please indicate the ICH activities that interest you

Annual membership fee is US$20.  Checks should be made payable to:

International Connections of Houston