FAMILIES WITH CHILDREN FROM CHINA

CENTRAL FLORIDA CHAPTER

2010 MEMBERSHIP APPLICATION                               

 

1.                  Print this from, enter requested information and mail with a $25 check payable to:

2.                  FCC-CF Membership, 398 Blythville Avenue, Deltona, Fl 32725-9017

3.       Questions?  E-mail Jean Dexter:  ctrpjd1@ocnjcc.org   

                       

MEMBERSHIP BENEFITS

--An opportunity for your children and parents to make new friends                              

--Special planned events planned the third weekend of every month (unless specified)

--Access to an FCC-Central Florida Membership Directory

 

Date:_______________________

 

CHECK ALL THAT APPLY:

 

 

                       China Adoptive Family_______

                       Waiting Family_____________                                                           

                       FCC Organization___________

                       Friend____________________

                       New Member______________

 

 

Are you an adoption agency/professional or other organization?

                        (If yes, please indicate)______________________

 

FCC-Central Florida Directory

 

Do you wish to be included in the FCC-Central Florida Directory?  Yes_______  No_______                                    

                       

            FCC-CF database, directories and membership lists are for he sole use of FCC-CF adoptive and prospective adoptive families.  They may not be used for commercial or any other purposes without the written consent of the FCC-CF Board.  Directories are made available only to the families listed in it.

                                                                                                           

Parent’s name(s)________________________________________________________________

 

Home Address:_________________________________________________________________

 

City________________State____________Zip_______________________________________

 

E-mail address(es)_______________________________________________________________

 

 

Phone(s): Home_________________Work_________________Mobile____________________

 

Children (Please also include birth children.  Use additional paper if necessary.)

 

Name(s)                     Birth date               Adoption Agency        Adopted from          Agency

                                                                                                   (City/Province)

 

Volunteering: (Select first and second choice:)

 

The events we hold each year rely on volunteers to help plan and staff.  We ask that every member consider volunteering so that work is distributed throughout our membership.  Please indicate your first and second choice for helping in any of the following events:

 

Chinese New Year Celebration______________

 

Easter Egg Hunt_______________

 

Moon Festival Beach Weekend________________

 

Newsletter articles________________

 

Cultural research (to incorporate into events)_________________

 

Other Activites_________________

 

We give our (my) approval for my child’s picture(s) and first name to be used on the              FCC-Central Florida website:              Yes______   No________