Membership Registration Form

Website designed by Robert Sayon Morris 763-533-1952

Organization of

Liberians

in Minnesota

Date:

Last Name

First Name

Address

City/State

Zip Code

E-mail

Home Phone

Cell Phone

Dues $5.00 a month

*Amount Paid:

Signature

Thank you!

Organization of Liberians in Minnesota

7001 78th Ave N

Suite 200

Brooklyn Park MN 55445

Tel. 763 208 5739

*Click here to pay online using your Debit or Credit Card

if you have not already paid your dues.

You have the option to fill out the application form online or copy it, fill it out and mail it to the address below