|
 Join
the CCIH Network Today!
|
check
below
|
Type of Membership |
Cost/year |
| |
Individual Full Member |
$25.00 |
| |
Individual Supporting Member |
$50.00 |
| |
Limited Income Member (e.g., student,
senior) |
$15.00 |
| |
Organizational Regular Member |
$100.00 |
| |
Organizational Supporting Member |
$500.00 |
|
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below
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Feel free to submit
the names and addresses of others who would
appreciate receiving
information on CCIH and The CCIH Forum.
Make checks payable to "CCIH"
Complete the form below. Please
print clearly.
Send to: Connie Gates, CCIH,
PO Box 291, Carrboro NC 27510
For more information:
Tel: (919) 929-0650 or E-mail Connie_Gates@Ecunet.org
Name and degree:_____________________________________________________
Organization (if any):___________________________________________________
Address:____________________________________________________________
City, State, Zip (Country):_______________________________________________
Telephone: (_____)_________________ Fax:
(_____)________________________
E-mail:_____________________________________________________________
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