Application
Form for Retirees
This
form must be accompanied by payment (SF-1187A,
check, or credit card) in order to be processed for membership.
|
Name
______________________________________________________
Address_____________________________________________________________
___________________________________________________________________
Home
phone_________________________________________________________
Work
phone_________________________________________________________
E-mail______________________________________________________________
Social
Security#______________________________________________________
All
retired FS employees, surviving spouses, and other federal retirees
who served overseas in a diplomatic capacity are eligible for membership.
__
Retired FS __ FS Spouse __ Retiree Associate
| FS
Annuity |
Annual
Dues
|
Monthly Annuity Deduction |
| over
$75,000 |
$159.55 |
$13.30 |
| between
$50-75,000 |
$127.50 |
$10.60 |
| between
$25-50,000 |
$95.40 |
$7.95 |
| under
$25,000 |
$63.70 |
$5.30 |
| FS
spouse |
$50.00 |
$4.15 |
| Retired
Associate |
$60.00 |
n/a |
| Associate
|
$98.05 |
| Lifetime
Membership |
$1000.00 |
n/a |
Please
return this application with your check made payable to AFSA to
the address below:
American
Foreign Service Association
PO Box 98026
Washington, DC 20077-7093
To
apply via credit card please fill out the information below and
fax to (202) 338-6820:
Credit
Card Information: ____Visa ____MasterCard $___________________
Name
as it appears on card______________________________________________
Credit
Card #____________________________________Exp. date______________
Signature_____________________________________________________________
Membership
dues are tax-deductible as a business expense.
Tell
me more about these AFSA benefits:
__
World Issues
Forum
__ Diplomats Online
__ AFSA
Elderhostel
__ Foreign Affairs Reserve Corps
__ Writing for the Foreign
Service Journal
__ Minority Mentoring Program
__ Scholarship
Information
__ AFSA's Insurance
Programs
__ Participating in an AFSA Committee
__
Other ______________________________
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