Name(s):

Title (if any):

Affiliation (if any):

Address:

City:

State:

Zip:

Telephone:

Fax:

Email:

I will remit annual dues as checked below:

In addition to my annual membership dues, I enclose this amount as a tax deductible contribution to the World Affairs Council of Pittsburgh.

None $100.00 $200.00 $300.00 $400.00 $500.00 $600.00 $700.00 $800.00 $900.00 $1000.00

Once your form has been submitted, Susan Jackson Dunsey, Member and Community Relations Director, at 412.281.1259 or by email, will contact you by phone or email to complete your membership!

If you need assistance before then, please email or contact Susan Jackson Dunsey at 412.281.1259.

I would like to. . .

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