SEACAA
Southeastern Association of Community Action Agencies
2006 Dues Invoice

$200.00
Dues for January 1 through December 31, 2006
Federal ID #61-1040243
Please make the check payable to SEACAA for the amount of $200.00 and
mail along with the completed form below to:

SEACAA
c/o Jim Davenport, Treasurer
Post Office Box 490
Barbourville, Kentucky  40906

Dues Information Sheet
Print, mail with payment to above address.
Date:  ____________________

Agency Name:

Address:

Executive Director:

Board Chair:

Phone Number:

Fax Number:

Email Address:

Website Address: