KSCC - Item No. 2 - Minutes 4-7-10■
ROSEMEAD
E-mail Address:
Mailing address (if
Membership Dues (Tax
Membership
I am interested in the Sister City of:
Keelung. Taiwan Other:
My interests include:
Visiting a sister city Business Contacts
Being part of an official delegation Cultural Programs
I verify by my signature that the information contained in this appl
supporting documents submitted with it, are truthful in every respe
I will represent the City of Rosemead, the Rosemead Sister City A
United States of America in a way that brings credit to all I represe
Print Name:
Signature:
tion, as well as the
and that, if selected,
ciation and the
Date:
Please make your check payable to R.S.C.A.
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ROSEMEAD SISTER
8838 E. Valley Blvd.,
Name:
C
N
IATI
9171
Telephone:
Membership Dues (Tax
$100
$300
I am interested in the Sister City of:
_ Cell:
Keelung, Taiwan Other:
My interests include:
Visiting a sister city Business Contacts
Being part of an official delegation Cultural Programs
I verify by my signature that the information contained in this application, as well as the
supporting documents submitted with it, are truthful in every respect; and that, if selected,
I will represent the City of Rosemead, the Rosemead Sister City Association and the
United States of America in a way that brings credit to all I represent.
Print Name: Date:
Signature:
'94
Please make your check payable to R.S.C.A.
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