Join the Conscious Aging Network of New
Mexico
To join
CAN-NM, print this page, fill it out and send it with your check to:
CAN-NM, c/o Paul Swanson, 1189 Laurel Loop
NE, Albuquerque, NM 87122
We
will notify you by email when we receive your check.
○ I
want the benefits and responsibilities of Active
Membership for one calendar year (fee $25)
○ I
support the work of CAN-NM and want the benefits of Supporting Membership for one calendar year (fee $15)
○ I
would like to make an additional unrestricted
contribution of $_______ to further support the important work of CAN-NM
○ I
would like to make an additional scholarship
fund contribution of $_______ to support workshop attendance by those who
need a little extra help
Name:
__________________________ Email: ___________________________________
Address:
_________________________ Telephone:
_______________________________
City, State,
Zip ________________________________ Date:
_________________________
Other
Comments _____________________________________________________________
____________________________________________________________________________
Total
amount enclosed (make checks payable to CAN-NM) $_________________