MEMBERSHIP IN APPA

 

 

 Individual            $20                                          Return to:        APPA

 Family                 $40                                                                 P. O. Box 250566

Corporate            $75                                                                 Atlanta, GA 30325

Lifetime                $400

Additional Contribution _____                             Make checks payable to:  APPA 

 

Name(s) ____________________________________________________

 

Address_____________________________________________________

 

City State Zip________________________________________________

 

Telephone___________________________________________________

 

Email Address_______________________________________________­_

 

Please circle one.

  1. I am a new member
  2. I am renewing my membership
  3. I’ve already sent my tax-deductible annual membership contribution, but my contact information has changed as shown above.
  4. I am unable to contribute at this time but would like to receive the APPA News

 

Annual contributions help to educate the public and health care community concerning polio.  We respond to the needs of individuals who suffer from post-polio syndrome through group meetings, educational programming, newsletters and advocacy.  APPA is a 501C3 nonprofit corporation.  All contributions are tax deductible.

 

We need you!  Would you be willing to serve APPA in any of the following areas?

Membership outreach (phone calls to shut-ins) ________________________________

Newsletter (write articles, proof read) _______________________________________

Public Relations ________________________________________________________

Fundraising____________________________________________________________

Program planning _______________________________________________________

Data base assistance _____________________________________________________

APPA phone tree help____________________________________________________

Assist with answering APPA phone line _____________________________________

Planning a conference ____________________________________________________

Assist with social events __________________________________________________

 

                                                                                                                       

10/2006