President’s Circle Membership | Urban League of Louisiana

URBAN LEAGUE OF LOUISIANA PRESIDENT’S CIRCLE MEMBERSHIP

Date:

CONTACT INFORMATION

Name

First Name

Last Name

Company Name

Title/Position

Primary Mailing Address

City

State

Zip

Country

Phone

Emaila valid email

PROCESSING YOUR MEMBERSHIP DUES

Item	Qty	Total
President's Circle Membership	1	1000.00

Annual Charge $xxx

INVOICE

Please invoice me

Once you hit submit you will be taken to the PayPal website to complete your membership payment. Thank you!