Print this form and mail or fax
it with payment to: China Institute, 125 East 65th Street, New York,
NY 10021-7088 USA, Fax: 1-212-628-4159
Yes! I'd like to join the Renwen Society
one year two years three years
Individual Membership $55 ($40 tax deductible)
Student and Senior $40 ($25 tax deductible)
Mr. Mrs. Ms. Miss Mr. and Mrs.
City _____________________________________ State ___ Zip ________
Phone(home) _____________________ (work) ________________________
Fax _____________________________ Email _________________________
I have enclosed my check, payable to: China Institute
Or charge my Visa MC AmEx Discover
Number _________________________________ Exp. Date _______________
My employer has a matching gift program that will increase my
support to China Institute. I have enclosed my company's form.
This is a gift membership.
The name on the membership card should read: