Patron Membership | Urban League of Louisiana

URBAN LEAGUE OF LOUISIANA PATRON MEMBERSHIP

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Date:

CONTACT INFORMATION

Name

First Name

Last Name

Title/Position

Primary Mailing Address

City

State

Zip

Country

Phone

PROCESSING YOUR MEMBERSHIP DUES

Item	Qty	Total
Patron Membership	1	250.00

Annual Charge $xxx

INVOICE

Please invoice me

Once you hit submit you will be taken to the PayPal website to complete your membership payment. If you selected the "Invoice me" option, simply close the PayPal window post submission. Thank you!