The active involvement and financial contribution of many individuals makes the work of the Environmental Health Strategy Center possible.
To become a member of the Environmental Health Strategy Center please print this form, fill it out, and mail it in with your contribution. Thank you for your support!

Name
Address
Town State Zip
Phone
Email

Yes! I want to help the Environmental Health Strategy Center protect public health from toxic chemicals and dirty technologies. Enclosed is my membership contribution of:
$30    $60    $100    $250    $500    Other $

Enclosed is my check payable to the Environmental Health Strategy Center.

Please charge my credit card $.
MC/Visa # Exp. Date
Signature

Please print this form, fill it out, and mail it in with your contribution.
Environmental Health Strategy Center, P.O. Box 2217, Bangor, ME 04402
Your donation is tax deductible and greatly appreciated.


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