The National Lymphedema Network -Membership in the NLN

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Become a Supporting NLN Member Today

Many Convenient Ways To Join

Pay By Charge:

Enter NLN's store and click on "Membership" to join today and pay by charge online (secure) OR call (415) 908-3681 to charge by phone.

Pay By Check or Money Order:

Simply fill in the form below, print, and mail with your payment to:

National Lymphedema Network, Inc.

116 New Montgomery Street, Suite 235

San Francisco, CA 94105

As a non-profit organization, we depend on our members and affiliate members for financial survival. Every year we educate, inform and refer hundreds of thousands of lymphedema patients and healthcare professionals, continually expanding our informational network and working towards our goal of making lymphedema a household word, and a recognized condition in American medicine.

Your generous support makes our work possible.

With a yearly financial contribution, you receive four issues of LymphLink, the quarterly NLN news publication, member discounts on educational materials and special NLN events (such as the international NLN Conference on Lymphedema Lymphedema for health care professionals or the NLN Patient Summit), online access to LymphLink article reprints, a free NetPal or PenPal posting, and priority call return.

If you would like to make an additional support donation to the NLN, please click here OR enter the amount in the box below and submit with your membership. To make your donation in honor of a loved one, please check the appropriate box and fill in the information for your honoree (or include this information when making an online donation). We will be happy to send an acknowledgement card on your behalf.

Thank you for your interest in joining the NLN family of members. We are here for you because of the generous support of individuals like you: people who believe that lymphedema patients, the general public, and health care providers should have access to education, information and training, and quality lymphedema care covered by health insurance providers. Together, we are working toward these goals and more. We look forward to hearing from you and welcoming you aboard.

Note: The National Lymphedema Network, Inc. (NLN) is a donation-supported, tax-exempt 501(c)(3) non-profit organization (Federal Tax ID#943068338). All donations are tax-deductible to the full extent of the law.

NLN Mail-In Membership Application:

Fill in, Print, and Mail to NLN with check or money order. To order by charge, click here.

(Note: You can also e-mail NLN with your name and address and we will be happy to send you membership information via postal mail.)

1. Gift Subscription (Optional)

This is a gift subscription from (your full name):

2. Member Information

Name:
Address:
City:
State:
Zip/Country Code:
Country (if outside US):
Phone (in case of problems):
Email Address:
	Please add me to the NLN email Action Alert network for special announcements!

3. Level of Support

$50.00	Individual in U.S. (Personal Checks, Residential Addresses Only)
$70.00	Individual Canadian (Int'l Money Orders, Residential Addresses Only)
$75.00	Health Professional (MD, PT, OT, RN)
$90.00	Individual Int'l (Outside U.S./Canada, Int'l Money Orders, Residential Addresses Only)
$100.00	Non-Profit Group/Organization up to $150K (must submit copy of 501 (c)(3) status)
$150.00	Non-Profit Group/Organization $151K & up (must submit copy of 501 (c)(3) status)
$250.00	Institution/Corporation (all employees receive NLN discounts)

4. Additional Donation (Optional)

I would like to make an additional donation of:

In Honor Of:	Mr. Ms. Mrs.
Honoree's Name:
Honoree's Address:
City:
State:
Zip:
	Please do not send acknowledgement to my honoree.

5. Total Enclosed

6. Comments (Optional)

Additional Comments?

(Areas of this form with a dark blue background must be filled in. Thank you.)

Please complete this form, then print it from your browser and mail with check or money order to this address:

National Lymphedema Network, Inc.

116 New Montgomery Street, Suite 235

San Francisco, CA 94105

Thank you. We look forward to welcoming you aboard as our newest member!

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