Home
About Us
Why Us
Events
Membership
Web Links
Mission
Services
Contact
Individual Membership
USPAACC Midwest Chapter
Varghese Chacko, President
2567 Greenleaf Road
Elk Grove Village, IL 60007
847-758-9288 (Phone)
847-364-3621 (Fax)
www.USPAACC-Midwest.com
Chacko@USPAACC-Midwest.com
APPLICATION FORM
Minority Business
$75.00 / Year
Non-Profit Organization
$25.00 / Year
Student
$15.00 / Year
Name
Company
Title
Address
Phone
E-mail
ASIAN - AMERICAN SCHOLARSHIP FUND
Yes
I would like to make a contribution
No
Not at this time
$
Amount
(If You Answered Yes)
Contributions are tax-deductible under IRS Code 501 (c)
Payment Method
Company / Personal Check
Check Payable to: USPAACC
Total Amount: $
© US Pan Asian American Chamber of Commerce-Midwest. All Rights Reserved
Website Designed and Maintained by
Polymorph Media Solutions LLC