Egyptian American Organization Membership & Renewal Application Forms www.eaous.com Po. Box. 5194 P.V.P, CA 90275 Email: membership@eaous.com Please send the completed application to the address above Your signature is required to process your membership application

Membership Categories:   Please select one of the following – "membership is from January to December"     REGULAR MEMBERSHIP ------------------------------------------------------------$ 60.00   FAMILY MEMBERSHIP (includes spouse & children under 13 years) -------------$ 70.00   STUDENTS (between ages 13years – 22 years) ----------------------------------$ 15.00   ASSOCIATE (Egyptians in temporary stay in the US) ----------------------------$ 30.00   YOUNG PROFESSIONALS (per year for 3 years) ----------------------------------$ 25.00   SUSTAINING MEMBERS ------------------------------------------------------------$ 99.00 –$ 250.00 DONATIONS: Please accept my donation to the organization for the amount of:   $25   $50   $100   $250   Other: _________________________ Name (Mr./Mrs./Miss/Ms./Dr.): * ________________________ Age: ________________________ Email: * ________________________ Mailing Address: ________________________ City: ________________________ State: ________________________ Zip: * ________________________ PHONE: Phone: ________________________ Home: ________________________ Work: ________________________ Cell: ________________________ Fax: ________________________ Best Way to Contact you:   email     phone     mail Marital Status: ________________________ Spouse's Name: ________________________ Email: ________________________ Cell: ________________________ Children Name ________________________ Age ________________________ Email: ________________________ Cell: ________________________   Name ________________________ Age ________________________ Email: ________________________ Cell: ________________________   Please help organize our activities – Please check all that applies to you and your family Interests:   Sports     Reading     Others ________________________________________   Social Activities   Career & professional seminars   Education or College related seminars   Singles' get-together   Other: ________________________________ Signature __________________________ Date:* __________________________ Disclaimer: Please allow us to better communicate with you and your family and complete this form. Please note the EAO will never intentionally share this information with other members or any other 3rd party.