African American Lupus Foundation, Inc.
Karmel Plaza
2910 Pillsbury Avenue South Suite 223
Minneapolis, Minnesota 55408
612.822.0206 – 612.822.0298
FAX – 612.822.0253
CAROL A. TAYLOR, EXECUTIVE DIRECTOR
Membership
Registration Form
INDIVIDUAL/BUSINESS NAME __________________________________________
ADDRESS _____________________________________________________________
TELEPHONE: Home ( )________________ Work ( ) ____________________
MEMBERSHIP TYPE:
(______) Alumni Member/Student
(______) Board Member
(______) Community Member
MEMBERSHIP PAID:
(______) $25.00 1 Year
(______) $45.00 2 Years
(______) $35.00 Alumni Family Membership
(______) I do not wish to be a member, but I’d like to make a donation in the
amount of $_____________ toward the Scholarship Program
(______) I would like to sponsor a student’s initiation fees in the amount of $150.00
Other Ways of Giving:
Sponsorships: Sponsor a student in the amount of $150.00/Other $__________
Partnerships: In the amount of $500.00/Other $__________ to be applied toward (Check One)
(______) One Semester Books/Materials
(______) Scholarship/Educational Programs
(______) Project Support/Activities
Matching Gifts: Contribute matching gifts from your employer. Check with your company to see if they have this option available.
.
Plan Giving:
Leave a legacy by naming African American Lupus Foundation Inc. in
your will, estate plan or life insurance policy
Levels of Donations/Pledges
|
Platinum |
$1,000.00 and above |
|
Gold |
$500.00 to $999.00 |
|
Silver |
$250.00 to $499.00 |
|
Bronze |
$100.00 to $249.00 |
|
Copper |
Up to $99.00 |
DONATE NOW:
Money Orders/Checks: We welcome you to send in money orders or checks along with the registration form to the following address.
African American Lupus Foundation, Inc.
Karmel Plaza
2910 Pillsbury Avenue South Suite 223
Minneapolis, Minnesota 55408
* All donations are tax deductible