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Join Us
Thank you for your interests in Joining HAPI. Please fill out the application below and let us know
how
you want to help HAPI by serving on our steering committee.
Yes, please sign me up to serve on the HAPI Steering Committee!
List my name on the HAPI Steering Committee to appear on the website.
I will contact my elected representative(s) on important issues.
I will recruit additional Steering Committee members in my area.
I will serve on the HAPI Legislative Board /track federal and state legislation.
I will send $1000 to join as an Executive member of the Steering Committee:
Special Recognition at Events
Quarterly newsletters
4 Tickets to Washington, DC policy briefing in
2008
I will send $500 to join as an Associate member of the Steering Committee:
Quarterly newsletters
2 tickets to Washington, DC policy briefing in
2008
I will send $250 to join as an Sustaining member of the Steering Committee.
Quarterly newsletters
1 ticket to Washington, DC policy briefing in
2008
A general contribution of $
is enclosed to help with membership expansion.
Name:
Company/Industsry:
Address:
City, State, Zip Code:
Phone Number:
Email Address:
Issues of Interest:
Referred By:
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