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Cie CA Membership Application 2011
Cie CA Membership Application 2011
BOX 31867 Grand Cayman KY1- 1208 ~CAYMAN ISLANDS Tel: 939-7426 / 916-6367 Working Together Building a Strong Foundation
MEMBERSHIP APPLICATION
FULL NAME BIRTHDATE (day/month) PHYSICAL & MAILING ADDRESS PHONE NUMBERS FAX or EMAIL CONTACT NAME OF SCHOOL OR PRESENT EMPLOYER: OCCUPATION & POSITION: QUALIFICATIONS / TRAINING EARLY CHILDHOOD EXPERIENCE SPECIAL SKILLS HOBBIES REFERENCE #1 REFERENCE #2 OTHER RELEVANT INFORMATION
I certify that the above information is accurate, and by signing this form, I am subscribing to and agree to the terms and conditions of the Articles and Memorandum of Association of the Cayman Islands Early Childhood Association that has been made available to me or my organization, and any amendments the CIECA may make from time to time, which is incorporated herein.
NAME: NAME:
PH. PH.
ADD. ADD.
P.O. BOX 31867 Grand Cayman KY1- 1208 ~CAYMAN ISLANDS Tel: 939-7426 / 916-6367 Working Together Building a Strong Foundation