BET-NAHRAIN,INC.
ASSYRIAN CULTURAL CENTER
3119 south Central Ave. Ceres, CA 95307
Mailing Address: P.O. Box 4116, Modesto, CA 95352
A Non-Profit Public Benefit Organization
 
Membership Application
 
Annual Fee For single $25
Annual Fee For Married $40
 
 
Name: Spouse Name:
Address: City/State:
Zip Code: Country:
Telephone: Date of Birth:
  
Number of children below age 18: 

Please indicate language that you speak,read or write including Assyrian:

Education: indicate Schools and Colleges graduated from:

Are you presently a member of any other Assyrian organization? 
If yes, please provide details:    
     
Yes No
 

Any further information you may wish to provide or 
comments to make, please do so:
   
I hereby apply for membership in Bet-Nahrain (The Assyrian Cultural Center of Bet-Nahrain). when my application is approved and I become officially a member, I agree to conform and abide by all the rules and regulations as set forth in the bylaws and constitution of Bet-Nahrain.