Grand Family Authorization Form

 

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I am ,
(Check a box)

  Grand Deputy
  Area Grand Deputy
  Grand Executive
  Grand Director
  Committee Member
  Other
Please include additional information about your position in this box.

By completing and sending this authorization, I authorize www.caiorg.org (the California Grand Assembly website) to include the following information on-line. Please check the items you are authorizing and enter the appropriate information.

  Home Phone:
  Home Address:
  E-mail Address:
  Alternate E-mail Address:
Enter comments in this box: 

Website use of items checked above is AUTHORIZED. Please check the box.
For validation, please enter the name of the seventh bow station in this box in lower case letters: 

 

   

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03/30/2008

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