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The American Druze Societys mission is to perpetuate the universal teachings of the Tawhid Faith,

enhance fellowship among Druze descendants, advance Druze religious, literary and cultural knowledge
through education and research, and enable all Druze people through charitable work. Please join us in
keeping our goals and vision for the ADS. We depend on your membership, volunteerism and support!

Membership Category
$1,500 Life Membership-Husband and Wife
_____$1,000 Lifetime Member - Individual
_____$90 2016 Husband & Wife w/Children 17 years of age & under
_____$50. 2016 Individual (18 yrs+ and NOT a student)
_____$40..2016 Student
Would you like you name, phone
Tax deductible donation
and email to be listed in the
$__________ Total Payment
National Membership Directory?

Personal Information



Title: ____ Ms. ____ Mrs. ____ Mr. ____Dr. ____ Prof.
Name _______________________________________________
Street or PO Box _______________________________________
City/State/Zip ________________________________________
Phone (______) _______________________________________
Email Address _________________________________________
ADS Chapter _______________________________________
ADYA (Between Age of 18-35) _____ yes ______No
You may also register in 2 methods:

Method of Payment
Please Note No Cash Option. Only money order/check/CC
_____Enclosed is a check for $________________ payable to
The American Druze Society Check Number:_______________
Money Order Number:__________________________________
_____Please charge my credit card $ ______________________
Please PRINT name as it appears on card.
Card Number
Exp. Date |_______| / |_______|
Security code from back of credit card |____________|
Full billing address _____________________________________
Billing address phone number (________)___________________
Email address of CARDHOLDER
Signature _____________________________________________

1. online at:
No need to fill form if paying online.

2. Fill attached form and mail

with payment to:

American Druze Society

C/O Mr. Samer Abdul-Baki
18714 Golden Maize
San Antonio, Texas 78258
Please Note: All memberships have to
be directly paid to the National
treasury in order to receive Ballots
for voting. NO EXEPTIONS!