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DENTON LULAC_4366_RECHARTER 2013 LEAGUE OF UNITED LATIN AMERICAN CITIZENS l RE CHARTER APPLICATION 2013 lG l n LEAGUE OF UNITED LATIN AMERICAN CITIZENS 2013 RE CHARTER APPLICATION CONTACT INFORMATION FORM Council Number #4366 District 3 Name of Council DENTON LULAC Council #4 3 6 6 EIN Number E IN 91-1919 710 Is this a Young Adult Council? ❑ Yes ® No (See LULAC Constitution, pg. 22 for a definition of a Young Adults Council) Complete all the required information for the principal point of contact. All correspondence will be sent to this address. Name BLAS DANIEL HINOJOSA Council Office (President, VP, etc.) TREASURER Home Phone 940-206-9047 or 940-300-3171 Work Phone Address P.O. Box 981 City DENTON State TEXAS Zip 76202 Fax* Email dentonlulac@verizon.net *This is must be a dedicated fax line. tG C 7 n Contact Information Release Form In LULAC's ongoing effort to make our website a primary source for information pertaining to the Hispanic community we are designing a searchable online directory of LULAC councils. Through this directory visitors to the website, including but not limited to potential sponsors and partners, media, and constituents, will be able to locate local councils via the web thereby better facilitating operations of the league. This form is a contact information release waiver authorizing the LULAC National Office to post contact information on the LULAC website: www.LULAC.org. Contact information should be provided for the council president or designated representative. -------------------------------------------------------------------------------------------------------------------------------- I hereby grant permission for my contact information detailed below to be listed on the website of the League of United Latin American Citizens at www.LULAC.org. This permission shall be terminated when I leave the specified office, or when I retract this permission, whichever shall occur first. It is the duty of the council president or designated representative to keep contact information up-to-date for current officers. Fill out only the information you wish to be published on the web: Name: DENTON LULAC COUNCIL #4366 E-mail: dentonlulac@verizon.net Address: P.O. BOX 981 City, State, &Zip: DENTON, TEXAS 76202 Phone Number: Council Web Address: www.dentonlulac.com Council Issue Areas (check all that apply): ❑ Civil Rights ❑X Education ❑ Employment ❑ Health [Z] Public Policy ❑ Immigration ❑ Technology ❑ Women's Issues ❑ Economic Empowerment -------------------------------------------------------------------------------------------------------------------------------- Submitted by(required): Printed Name: BLAS DANIEL HINOJOSA Council Number: #4366 Signature: Date: MARCH 27, 2013 **If you do not have an email account and require assistance setting one up, please contact Jorge Trasmonte at the LULAC National Office, 202-833-6130.