For​ ​office​ ​use​ ​only​:

HMONG NATIONALITIES ORGANIZATION,​ ​INC​.

Date​ ​received:________________________ Check​ ​No.___________________________

Membership​ ​Contribution The​ ​Hmong​ ​Nationalities​ ​Organization,​ ​Inc.​ ​seeks​ ​to​ ​improve,​ ​promote,​ ​and​ ​advocate​ ​for​ ​the​ ​life,​ ​history,​ ​culture, socio-economic​ ​condition,​ ​security,​ ​and​ ​stability​ ​of​ ​the​ ​Hmong​ ​people.​ ​Membership​ ​to​ ​the​ ​Organization​ ​is​ ​open​ ​to any​ ​adult​ ​person​ ​who​ ​is​ ​passionate​ ​about​ ​the​ ​advancement,​ ​progress,​ ​and​ ​prosperity​ ​of​ ​Hmong​ ​and​ ​also​ ​aspires​ ​to the​ ​organization’s​ ​vision,​ ​mission,​ ​purposes,​ ​and​ ​principles​ ​as​ ​well​ ​its​ ​commitment,​ ​activities,​ ​and​ ​collective wisdom.​ ​An​ ​Active​ ​Member​ ​shall​ ​have​ ​the​ ​right​ ​to​ ​vote,​ ​run​ ​for​ ​office,​ ​petition,​ ​and​ ​engage​ ​in​ ​the​ ​affairs​ ​of​ ​the Organization.​ ​Your​ ​financial​ ​contribution​ ​will​ ​provide​ ​the​ ​necessary​ ​support​ ​to​ ​the​ ​Organization​ ​in​ ​its​ ​effort​ ​to advance​ ​the​ ​mission,​ ​activities,​ ​and​ ​collective​ ​interest​ ​of​ ​our​ ​community. Member​ ​Information Name:_________________________________________Gender_____________________________________ Address:_______________________________​ ​City:__________________State:_________​ ​Zip:___________ Phone:___________________________​ ​Cell:____________________________________________________ E-mail:___________________________________________________________________________________

Membership​ ​Contribution:​ ​Check​ ​the​ ​appropriate​ ​amount [​ ​]​ ​$____ [​ ​]​ ​$____ [​ ​]​ ​$____ [​ ​]​ ​$____ [​ ​]​ ​$____ [​ ​]​ ​$____ [​ ​]​ ​Pledge

Heritage​ ​Club Founders​ ​Circle Professional​ ​League Active​ ​Member General​ ​Member Community​ ​Supporter Amount_____________________________________________________________

Contribution​ ​is​ ​made​ ​payable​ ​throughout​ ​the​ ​year.​ ​Please​ ​submit​ ​completed​ ​application​ ​and​ ​contribution​ ​to:

Hmong​ ​Nationalities​ ​Organization,​ ​Inc. th​ 796​ ​E.​ ​7​ ​ ​Street

St.​ ​Paul,​ ​MN​ ​55106 Phone:​ ​651-774-0347​ ​Fax:​ ​651-774-2385 Thank​ ​you​ ​for​ ​your​ ​membership​ ​and​ ​financial​ ​support!