AFC4A Member Update

The purpose of this form is to update your member information for AFC4A. If you are not a member but would like to become one, please click here and complete our registration form.  When you push the submit button at the bottom of the form, it will be sent via Email to Jack Stratford, VP for Membership who will update your member profile in our database.  This information is not provided to any source outside AFC4A and our members are prohibited from using the information for business purposes.

Please provide the following contact information.  The fields with an asterisk(*) are mandatory:

*First name

*Last name

 

  

Job Title

Company Name

*Home address(street). This is

where we will mail announcements.

Street Address (cont.)

*City

*State (please use two letters)

*Zip/Postal code

Country

Day Time Phone

*Evening (Home) Phone
   

*E-mail(please type over)

Why are you submitting this change?

This is a new home address
This is a new company
Only my contact information (e.g., telephone, Email) has changed

We intend to make this information available in the AFC4A directory, do you agree?

This information may be published in the AFC4A directory.
Please keep this information private.


 

Do you have any special interests in AFC4A that you would like to let us know about.   This includes participation on committees, assisting at AFC4A functions as well as initiatives you believe AFC4A should undertake?


Please review the information you have entered to ensure accuracy and either edit it push the Submit Form button.  If you push the Reset Form button, all information will be erased and nothing will be recorded or forwarded.

Thank you for updating your member information.

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