Membership Form
Please 1) Fill out the form except for the credit card, 2) print it, 3) Write in the Credit Card, 4) mail it to:
Americans For A Safe Israel
1751 2nd Ave
New York, NY 10128
or
Fax the printed form to AFSI at
(212) 828-1717
First & Last Name
Address
City
State
Zip Code
Phone Number
Fax
Email
Type of Membership
Click To Select
$50 Regular membership
$20 Student membership
$100 Sustaining membership
$500 Sponsor
$1000 to join the AFSI Chairman's Advisory Council
$2500 to join AFSI's National Council
Type of Payment
Click To Select
Check
Credit Card
Paypal
Other
Credit Card # (if you are using one)
Expiry
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
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