Join the National Adrenal Diseases Foundation
 Memberships & Donations
Membership donations cover only the costs associated with
producing NADF News, education materials and maintaining the organization.
Your additional donations will help us to do more!
To become a member of NADF, please send your check for $25.00
< CLICK HERE TO PRINT OUR NEW (PDF) DONATION COUPON >
* Print and complete this page to mail with your fee or donation *
National Adrenal Diseases Foundation
505 Northern Boulevard
Great Neck, NY 11021
| |
Condition of Interest |
| _______ Become a Member $25.00 |
_____ Addison's Disease |
| |
_____ Congenital Adrenal Hyperplasia |
| _______ Renew Membership $25.00 |
_____ Cushing's Syndrome |
| |
Other ____________________________ |
Donate additional $__________ $25 $40 $50
$100 $250 $500
Name ____________________________________________________
Address ____________________________________________________
____________________________________________________
Phone # __________________________________
Email Address __________________________________
Special Instructions or Comments:________________________________________
_________________________________________________________________
I am very happy with my doctor and would recommend him/her:
Physician Name: ______________________________________________________
Physician Specialty: ____________________________________________________
Physician Location: ____________________________________________________
Do you give NADF permission to share your contact information (e-mail & phone number) with other people with adrenal disease who might want to share?
Circle one: Yes or No
< CLICK HERE TO PRINT OUR NEW (PDF) DONATION COUPON >
Make checks payable to the National Adrenal Diseases Foundation or NADF
Memberships & donations to NADF are tax deductible.
NADF is a registered 501(c)(03) public charity EIN# 11-2777036
Privacy: Contact information we receive will not be shared with or distributed to
any other organization or persons except as may be required by law
or by your specific request or permission.
|
