MPCA Membership/Renewal Form
Name ______________________________
__________________________ ___________________ _____________________ Country and Years of Service ______________________________
_____Assignment ____________________________ ___________ Address _____________________________
__________City______________ _____________ST______ZIP__ ______________________ Phone ______________________________
____________ Email _____________________________ ____________________________ _____ I would like the MPCA newsletter sent to me via email at the above address. (This saves the organization on printing and postage costs.)
Milwaukee Peace Corps Association membership is not restricted to RPCVs, but is also open to prospective volunteers, PCV parents or anyone whose goals are the same as those of the Peace Corps. Anyone interested in being added to the mailing list can contact Peter Lee at lee@uwm.edu. Unfortunately, due to production costs, if we do not receive your dues after 3 monthes, we’ll have to remove your name from the mailing list. Paid members will receive an MPCA Directory. If you pay dues to the National Peace Corps Association and list yourself as being affiliated with the Milwaukee group, your dues are paid with your national membership.
All renewals are due on January 1.
______ $15.00 Minimum MPCA Dues ( New members $7.50 after July 1)
______ $22.50 Common Household (New members $11.25 after July 1)
______ $__________ Other donations
_____ MPCA currently shares contact data with the National Peace Corps Association. If you do NOT wish to have your information shared in this way, please check here.
Please fill in this form and send it with a check made out to Milwaukee Peace Corps Association to:
Milwaukee Peace Corps Association - P.O. Box 511322 - Milwaukee, WI 53203-0221