:: Information Request ::

The Afifi Shriners are located in Tacoma, Washington. Information requests for other geographical
areas will be forwarded to the Shrine Center closest to your location.

Your Name:
Your e-mail address:
Your phone number:
Your mailing address:

I want information on (check all that apply):

how to rent the Shriners building in Tacoma, Washington.
how to become a Shriner.	how to get medical care for a child.
what the Shriners Do.	how to volunteer or donate to the Shrine Hospitals.
who the Shriners are.	Shriner history.
other groups that are affiliated with the Shriners (Masons, Daughters of the Nile, York Rite, Scottish Rite, Grotto, Amaranth, Eastern Star, White Shrine of Jerusalem)

Additional information or comments:

*Your name, e-mail address, phone number, and mailing address must be filled out and
you must check the information that you want to receive or this form will not process!