Please fill out this application and mail with your check
(payable to HealthyPlanet) to:
HealthyPlanet, P.O. Box 163, Huntington, NY 11743
I WOULD LIKE TO JOIN . . .
I'D LIKE TO HELP WITH . . .
Anything needed Monthly Phone Calling Office Help (Huntington)
Healthy School Lunch Program Data Entry Newsletter/Writing
Core Group Potluck Organizing Advertising Sales Newsletter
Distribution Graphics/Artwork Public Speaking
Help with Mailings Media/Public Relations Fundraising
Photocopying Staff Table Cooking Research
Computer Help Health Partnership Program Poster Distribution
TYPE OF ANNUAL MEMBERSHIP . . .
BENEFACTOR $1000 SUSTAINER $500
PROFESSIONAL $125 STUDENT/SENIOR $20
FAMILY (includes 2 cards) $50 INDIVIDUAL $35
*Monthly Pledge (*Send Me Authorization for Auto Payments)
TYPE OF PAYMENT . . .
Check (payable to HealthyPlanet) Credit Card
|Type of Credit Card:|
|Name on Credit Card:|
|Credit Card Number:|
(Family Level and Higher Receive 2 Discount Cards; Please allow 2-4 weeks for membership packet to arrive)
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