ASSOCIATE FORM Full Name *Address Home Phone Number Work Phone Number Cellular Phone Number Email Address *Skype Username (We use Skype to communicate so we recommend you open a free account)Nationality Country of Residence Identification Number Profession Place of Work Marital Status Availability to Focus on CECOS In which ways can you contribute to SCLC? Annual Donation or SponsorCorporate DonorTechnical SupportCommunity ContactsFrequent VisitsAdministrative SupportWeb DesignOther (Please indicate below) Are you willing to attend annual general assembly meeting in Sarapiquí, Costa Rica? YesNoHow did you find out about the SCLC? Why are you interested in working with SCLC? To be filled in by one who nominatesType of Nomination Active AssociateHonoraryAffiliate VerificationPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank:
