"*" indicates required fields Contact InformationName* First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneEmail Tickets and EventsEvent: French Music Concert Date/Time: Thursday, September 7, 7 pm Location: Haymount United Methodist Church sanctuary (1700 Fort Bragg Rd.) Price: General admission $15, Students $10Concert Ticket - General Admission Quantity Price: Concert Ticket - Students Quantity Price: $10.00 Quantity Event: Lafayette Trail Tour Date/Time: Saturday, September 9 - coffee and croissants at 8 am, tour begins at 8:30 am Location: FILI building (210 Burgess St., downtown Fayetteville) Price: $20Dance Workshop Tickets Quantity Price: $20.00 Quantity Luncheon Tickets Quantity Price: $40.00 Quantity Dance Workshop Tickets (Lafayette Society Members) Quantity Price: $10.00 Quantity This field is hidden when viewing the formI've already purchased my Bicentennial Ball ticket(s) - please send me my free Dance Workshop ticket(s)! (Quantity)This field is hidden when viewing the formI Would Like To Pay ForMembershipI Would Like To*Please Choose OneJoin As A New MemberRenew My MembershipMembership Levels*Please Choose OneIndividual (student or active duty military) - $10Individual (regular) - $15Family (student or active duty military) - $20Family (regular) - $30Friend - $50Donor - $100Founder - $250Additional Members (Family Level and Above)* First Last Additional Members (Family Level and Above) First Last Additional Members (Family Level and Above) First Last How Did You Hear About Us?If this is a family membership (or higher) please complete the following:Family Member 1 Name First Last Family Member 1 RelationshipFamily Member 1 Email Family Member 2 Name First Last Family Member 2 RelationshipFamily Member 2 Email Family Member 3 Name First Last Family Member 3 RelationshipFamily Member 3 Email DonateI would like to donate Please enter dollar amount hereI'd like to add $1 to help cover our PayPal processing fees.Please Select OneYes I Would!Not this time.Total We’re always looking for volunteers to help with the birthday celebrations, the Medaille Lafayette, the annual luncheon, and our many other events. Would you like to learn more? Yes I am interested in contributing the following skills:CAPTCHA