Prader-Willi Alliance of New York, Inc.

Professional Membership Payment

Dues are $40 per person.  Your membership entitles you to one (1) vote in the organization.  You may enroll as many additional members' as you like at $40 per person.

Dues
Additional Tax Deductible contribution
Additional Tax Deductible contribution for Research
Total Amount of Payment **

Name**:     
** Total Amount of Payment and Name CAN NOT BE BLANK
Organization:
Address:
City, State, Zip:
Telephone:
Email:


Notes:


 

 

Join the Alliance and help support our work for individuals with Prader-Willi syndrome throughout our state of New York!

 

PO BOX 222; Baldwinsville, NY 13027 * Phone:  (716) 276-2211 *  (800) 442-1655 * 

New York State Chapter of