Membership Form - Options For Independence

Join Us!
We will gain strength and expertise from
your experiences as well as from our own.

Fill out the Membership Form below and submit over the web. Your membership will be activated when you send a check or money order for the amount specified. Or, you can download the Membership Form in Adobe PDF format, to print and mail into Options for Independence with your check or money order. Please note, in order to download this form, you must have Adobe Acrobat Reader installed on your computer. If you do not have this software, click on the Adobe icon to download a free copy now.

PLEASE NOTE: Your browser must be able to support "forms" (eg. Netscape, Explorer, Lynx). If you are using some other browser, please e-mail your membership request with all the information below to:

options@optionsforindependence.org

Your membership contribution allows us to defray the cost of providing free services. We are funded by the Office of Vocational and Educational Services for Individuals with Disabilities (VESID) a part of the N.Y. State Education Dept., private donations and through fund raising activites. The benefits of an Options' Membership are a quarterly newsletter, voting privileges at our Annual Meeting, invitations to special events and a one year membership card.

You May Join by Enrolling in One of the Following Memberships:

$100.00

$50.00

$25.00

$10.00

Your Name:

Address: (Include Apt., City, State and Zip)

Phone Number:

Make checks/money orders payable to:
Options For Independence, Inc.

THANK YOU!

If you have filled out this form completely, you may press the "Submit" button to send this form. If you would like to clear this form and start over, please press "Reset". If you would like to exit this form with out submitting any information, please press "Exit".

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