CMC South Mission Mobilizer  

@

Mission Mobilizer Application

CMC South 2018

@

 

 

Contact Name:

     First Name:       Last Name:         

Mission Mobilizer rebate check should be made out to:
@

住址 Address:  

城市 City:     State:        郵遞區號 Zip code:

電話 (Home/cell Phone):             
電子郵箱 E-mail: 
@
  I agree that I will distribute the badges to those who will be using my Mobilizer code. 

If above contact name and address do NOT belong to the badge distributor, please enter the requested info below:

Name:   
Address:

@

 

**Thank you for becoming 2018 CMC South Mission Mobilizer. You will receive your mobilizer code via email after you submitted the form. If you have any questions, please contact our CMC coordinator.
@

@

@

@

@

@

@

@

 

 

 

 

 



    

 

  

    
@

 

聯絡 CONTACT:

        如有問題請聯絡 Sue Chen:  shuang@afcinc.org

717-687-8564 Ext: 0