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Please print this page and place it in an envelope and mail it with your contribution to:                                                                     Million Member Assembly                                                                                                                                                                                        (Travel Enrollment Form)                                                                                                                                                                                        P. O. Box 1052                                                                                                                                                                                                    New York, NY 10150-1052                                                                                                                                                                                 Make your check payable to: Million Member Assembly

For In-kind donation and comments, please mail this form to:                                                                                                           Million Member Assembly                                                                                                                                                                                  In-Kind Contribution Dept.                                                                                                                                                                                600 West Oak Ridge Road, Suite B                                                                                                                                                              Orlando, Florida 32809

Please identify and describe yourself:

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Please provide the following contact information:

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Please select the following travel category:

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Select any of the following options that apply:

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Choose one of the following other options:


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Please print this page and place it in an envelope and mail it with your contribution to:                                                                     Million Member Assembly                                                                                                                                                                                        (Travel Enrollment Form)                                                                                                                                                                                        P. O. Box 1052                                                                                                                                                                                                    New York, NY 10150-1052                                                                                                                                                                                 Make your check payable to: Million Member Assembly

For In-kind donation and comments, please mail this form to:                                                                                                           Million Member Assembly                                                                                                                                                                                  In-Kind Contribution Dept.                                                                                                                                                                                600 West Oak Ridge Road, Suite B                                                                                                                                                              Orlando, Florida 32809

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