Does (do) your parent(s) (in-law) live with you? _______ Yes; ______ No.

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Home Address: (Preferred for mailing? Yes: [ ], No: [ ])

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Number Street Apt. #

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City State Zip + 4

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Phone Fax E-mail:

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Your Business Affiliation: Profession:

Business Address: (Preferred for mailing? Yes: [ ], No: [ ])

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Number Street Apt. #

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City State Zip + 4

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Phone Fax E-mail:

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Your SPOUSE' Business Affiliation: Profession:

Business Address: (Preferred for mailing? Yes: [ ], No: [ ])

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Number Street Apt. #

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City State Zip + 4

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Phone Fax E-mail:

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ARE YOU INTERESTED IN THE FOLLOWING ACTIVITIES:

* Social events:

Picnic: [ ] Restaurant Banquet: [ ] Karaoke: [ ]

Sports: [ ] Gathering: [ ] Movie: [ ]

Video: [ ] Meeting Chinese visitors: [ ]

Others:

* Information seminars:

Immigration: [ ] Insurance: [ ] Investment: [ ]

Real estate: [ ] Taxation: [ ] China visit:[ ]

Others:

* General services:

Chinese Library (books, newspapers, and other information): [ ]

Parents gathering: [ ] Child education (Chinese language school): [ ]

Others:

* Your hobby (this helps to organise activities):

Do you want to be the candidate for next Board - Yes: [ ], No: [ ]

Do you want to help organising any activities - Yes: [ ], No: [ ].

Please specify:

Membership Fee for 1997:

Please check the appropriate box below for your membership of 1997, and

remit the payment (make your check pay to the order of Chinese Friendship

Association of Portland). Thanks!

[ ] Family membership: $15.00 ------------ [ ] individual membership: $10.00