HACC - CHAC
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    • Membership Application
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              HACC/ CHAC Membership Application



Name....................................................................……………………...................................................
Address.................…………..…….……………………………………………….............
E-Mail.................................………………..........         Phone.............................................................
Place of Birth.................……………………............………….......................................................
Spouse’s name.& Place of Birth………………………….............................................................
Children’s names and ages ..................………….........…………………....................................
Languages spoken..............…….......………………………………...........................................
Profession / Trade........................…………........……………………….....................................
Employed by......................………..........…………………………...............................................
Hobbies / Interests.......................…….....………………………………..................................
Did you learn about the HACC from some of our members?   (Yes/No)…………….…...
If yes, from whom?....................................................................................................................................
If no, how did you find out about us?.................................................................................................
Have you attended any of our past events? (Yes/No)……..  If yes, how many?..................
Please choose the committee(s) you or your family members might be interested in helping:    
Arts [  ], Education [  ], Fundraising [  ], Membership [  ], Nominations [  ] , Publications [  ], Social [  ]

Signature..........................................…………………………………..Date.......................

Annual dues: Singles $ 25.00, Family $ 35.00, Organizations $ 50.00.
New Members: Add a one-time initiation fee $ 10.00.
Total: ................................      (Make checks payable to HACC).


Send Membership application with payment to:
HACC. Membership Committee
P.O. Box 25                                                 
New Britain, CT. 06050- 0025


Address:
Hispanic American Cultural Council 
P.O. Box 25.  New Britain, CT. 06050-0025
Meeting place:
Goodwin College. Conference Room, second floor.
1137 Main Street East Hartford, CT
.