Allen County Council on Aging, Inc.
233 West Main Street
Fort Wayne, Indiana 46802-1613
Phone: (260) 426-0060
Fax: (260) 426-0264
Transportation:(260) 424-2010
www.allencoa.com
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Allen County Council on Aging, Inc. 233 West Main Street Fort Wayne, Indiana 46802-1613 Phone: (260) 426-0060
|
Fax: (260) 426-0264 Transportation:(260) 424-2010 www.allencoa.com |
Membership
I would like to be a supporting member of the Allen County Council on Aging.
Basic Member: _____$5.00
Contributing Member: _____$10.00
Sponsoring Member: _____$25.00
Other: _____
Name: _______________________________________ Birthdate: ___________________
Address: _________________________________________________________________
City: ____________________________ State: ________________ Zip Code: _________
Telephone Number: ________________________________
Renewal: ______ New Membership: ______
