Lao Investment Club Member Information & Acknowledgment

	L A O I N V E S T M E N T C L U B ^Ž Helping you reach your long-term goals ^SM Sa Hatlavongsa, President Thongsouay Sakdarak, Secretary Scott Vongsikeo, Vice-President Toukta Hatlavongsa, Treasurer
Questions? E-mail us at service@laoinvestmentclub.com or visit us on the web at www.laoinvestmentclub.com

Lao Investment Club Member Information & Acknowledgement

1. Member Information

Member Name:

Date of Birth:

Social Security No:

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Mailing Address:

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City:

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State:

ZIP Code:

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Home Phone:

E-mail:

2. Member Acknowledgement

I hereby acknowledge having received and read the Partnership Agreement of the Lao Investment Club. I further acknowledge and understand the contents and meanings of the Partnership Agreement of the Lao Investment Club. Finally, I acknowledge and accept the terms and conditions set forth in the Partnership Agreement of the Lao Investment Club.

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Signature of Member	Date

3. Return Information

Please mail completed form to:
Lao Investment Club
Attn: Member Relations Office
45374 Zuma Dr.
Temecula, CA 92592

If you have any questions regarding the completion of this form, please e-mail the Member Support Center at laoinvestmentclub@etrademail.com

MIA