ASIAN AMERICAN PARENTS ASSOCIATION (AAPA), INC.

MEMBERSHIP APPLICATION FORM

AAPA welcomes you as a member, please complete the information below:
PRIMARY PERSONAL INFORMATION
Primary Role:
Salutation:

o Parent/Guardian

o Grandparent

o Teacher/Staff

o Sponsor

o Other_____________________________

o Mr. o Ms . o Mrs.

Name (First Name, Last Name): ________________________________________________________________________________

Organization/Title (if sponsor, organization, or corporation):___________________________________________________________
Address: _________________________________________________________________

State: ________

ZIP: ___________

County: Barrow Cobb Clayton Dekalb Fulton Forsyth Gwinnett Other:________________

Ethnic Heritage(s):_________________________________________ Language(s):_____________________________
Student(s):
Name:________________________________________ School:________________________________________Grade:__________
Name:________________________________________ School:________________________________________Grade:__________
Name:________________________________________ School:________________________________________Grade:__________

CONTACT INFORMATION
Phone (Home): ____________________________________________

(Cell):________________________________________

Email: _______________________________________________________@________________________________________

Please add me to the AAPA email list for updates and news.
I am interested in volunteering/leadership opportunities with AAPA. Please contact me on how to get involved with AAPA
committees.(e.g. membership, events, bullying prevention task force, newsletter, translations, board)

PAYMENT INFORMATION: Annual Calendar Year Membership (Jan 1. Dec. 31):

Select One:

Individual/Family ($10)

Organization ($50)

Corporation ($100)

Additional Donations and In-Kind Donations are appreciated: ______________________________

Total Amount Enclosed: _____

AAPA is a registered non-profit with the State of Georgia. AAPA is not a 501c3 organization and thus tax deductions are not permitted.

Please make checks payable to: ASIAN AMERICAN PARENTS ASSOCIATION, INC.
Mail to: AAPA, c/o Raksha, Inc., P.O. Box 12337, Atlanta, Georgia 30355
Questions: aaparentsga@gmail.com or 404-494-0362

Why Join AAPA? Get Connected | Speak Up | Engage

The Asian American Parents Association (AAPA) is a non-profit organization in Georgia whose mission is to be a resource for our
children, communities, and the school systems. Our vision is to empower parents of Asian American students to effectively engage with
their schools and to work as a community for a well-rounded education for all children.

AAPA BOARD USE: Payment Method: o Cash o Checkcheck # __________ Date:___________ Initials:______(0115)