Name(s): __________________________________________________________

Address:  __________________________________________________________

__________________________________________________________________

Phone:  Home:________________________ Work: _________________________

E-mail: ___________________________ Date: ____________________________
 

Membership Level: 
____Individual - $15/year 
____Family (2 people at same address) - $20/year 
____Supporting - $50/year 

Additional Contribution ________

Total Amount Enclosed ________

NOTE: Nothing of monetary value has been provided in consideration of these membership dues and additional contributions. AFORR is a nonprofit organization under Section 501(c)(3) of the Internal Revenue code, so donations are tax-deductible as contributions.

Are you a member of an Affiliated Organization? Please name: _________________________________________

Can you assist AFORR with any of the following?
___PUBLICITY     ____MEMBERSHIP   ____EVENTS 
___RESEARCH    ____OTHER: _________________

Make checks payable to AFORR. Please mail completed form to: 
     AFORR
     c/o Kennedy
     209 Whippoorwill Drive
     Oak Ridge, Tennessee 37830