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美国亚裔女性保护协会入会申请表
Membership Application Form of Association for the Protection of Asian women in America

1. 基本信息 / Basic Information

* Indicates required field

Name 姓名 *

First

Last

Gender 性别 *

Date of birth 出生日期（MM/DD/YYYY） *

Address 地址 *

Line 1

Line 2

City

State

Zip Code

Country

Telephone 电话 *

Email 电子邮箱 *

2. 教育和职业信息 / Education and Employment Information

最高学历 Highest Level of Education *

职业 Occupation *

公司 Employer *

职务 Position *

3. 加入原因和期望 / Motivation and Expectations for Joining

请简述您希望加入美国亚裔妇女保护协会的原因及您对本协会的期望 Please describe why you want to join the Asian American Women’s Protection Association and your expectations from the association: *

希望获得的帮助 Expected Support *

能为协会做的贡献 Contributions to the Association *

技能和兴趣 Skills and Interests *

4. 推荐人 / Referrer (if applicable)

推荐人姓名 Referrer's Name *

与推荐人关系 Relationship with Referrer *

5. 确认 / Acknowledgment

我确认以上填写的信息真实无误，我理解加入美国亚裔妇女保护协会后需要遵守其规章制度，并愿意积极参与协会活动。
I certify that the information provided above is accurate and truthful. I understand that membership in the Asian American Women’s Protection Association requires adherence to its rules and regulations, and I am willing to actively participate in its activities.

签名 Signature *

日期 Date（MM/DD/YYYY） *

I agree to receiving marketing and promotional materials

Submit 提交