| Membership Form |
| (Please print out this form and send it by fax or mail) |
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| In order to support women's health in Israel I would like to: |
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Become a member of the IAAWH ($25 membership fee) |
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Make a donation of $______ |
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Volunteer to lecture to women in Israel on the topic _________________________ |
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| Personal details |
| First name and family name |
_______________________ |
| Street |
_______________________ |
| City |
_______________________ |
| Code |
_______________________ |
| Telephone no. for clarifications |
_______________________ |
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| Form of payment |
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Included is a check for the amount of $____________ |
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