Please print this form and send it with your check to:  

Children's Medical Aid Foundation
Post Office Box 301
Sonoma, California 95476

Become a Supporting Member:
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Annual membership $50
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Family Rate $75
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Donor $500
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Patron $1,000
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Student/Senior $25
Other:
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Volunteer:
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Data Base Entry
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Web Assistance
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Newsletter Production
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Katmandu Fall Festival
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Fundraising Events
Other:
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Full Name:
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Street Address:
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City / State / Zip:
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Email Address:
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Phone:
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Fax:
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Comments:
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