Membership Form
Minnesota Rainbow Alliance of the Deaf
(MNRAD)

Today Date:

First name: Last name:

Address:

Phone Number:

E-Mail Address:

Birthday:

Special Needs/Accommodate:

Please check:
Gay
Lesbian
Bisexual
Transgender
Others

Membership is due annually. The membership cost $10 for a per person.

New
Renew
Membership

Please make money order for $10 if you mail it or you can pay cash or money order in person as MNRAD WILL NOT ACCEPT any personal checks! Sorry.
***Please Note: Once you membership expires on certain date, you will not receive letter/email until you renew your membership dues.***


Mail to:
MNRAD
c/o MCIL
1600 University Avenue West #16
St. Paul, MN 55104-3834

ATTN: MNRAD Treasurer


Please Cut and send to a member application in mail. Thank you!

For MNRAD Officers:

Received $: Cash or Money order On date of:

MNRAD Treasurer's Signature:

Please Sign your name


MNRAD Secretary's Signature:
Please Sign your name