OTAP Membership Form |
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| Please use this form to join or renew your membership in OTAP. Membership is open to everyone in the community. OTAP is committed to supporting Donor Awareness. Please join our cause. We meet on the third Wednesday of each month at a local restaurant. Dinner is at 5:30 and the business meeting will start at 6:30. We try to keep the meetings short and fun for everyone, so we welcome families to bring the kids. |
| Name_____________________________________________________________ |
| Address___________________________________________________________ |
| City_______________________ |
State___________ |
Zip_____________ |
| Email ______________________________________________________ |
Individual Membership
($10 Donation) |
| ___Candidate: Type: __________________________________________ |
| ___ Recipient: Type: __________________________________________ |
| ___Health Care Professional |
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| ___Donor Family Member |
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| ----- Name & Date: ____________________________________________ |
| ___Family Member of Recepient |
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| ----- Name __________________________________________________ |
Family Membership
($15 Donation) |
| --- Family Member Names: _____________________________________ |
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___ Newsletter Sponsor ($100 Annual Donation) Send business card |
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I would like to Donate: |
| -----____$50 ___ $100 ___$150 ___$200 - Other amount: $________ |
| ------------------ I would like to make a monthly Contribution of $________ |
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If you would like to donate some time we would welcome your help with any of the following: |
| ___ Karate Tournament |
___ Partners in Workplace |
| ___ Newsletter |
___ Scholarship Essay Contest |
| ___ April Awareness |
___ Publicity |
| ___ Membership |
___ Website |
| ___ Fund-raisers |
___ State Fair |
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OTAP is a non profit organization. All contributions are tax deductible. Thank you for your support.<br>
Make checks payable to: OTAP of New Mexico, PO Box 37217, Albuquerque, NM 87176
Phone: (505) 710-4462 |
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