Membership and Contribution Application Form

To become a Member or Contributor, please complete the following form and provide your credit card information. 

MEHR is a tax exempt non-profit organization and all contribution are deductible

 

Select type of membership:
Students
  $ 25 per year		 Standard
  $50 per year		 Active Members *
  $ 25 per month
Additional contribution:     Contributor:

Name

Title:              (Optional)

Organization:  (Optional)

Email 

Phone

Fax:              (Optional)

Address 

City 

State 

      Zip Code: 

Country:

Card Number:

    Expiration Date:

                                                             Security Code:    

  * Those who would like to become active members but cannot afford  the membership fee, will be exempted upon request.

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MEHR 
P.O. Box 2037
P.V.P., CA 90274, USA

Tel: 310 - 377 - 4590
Fax: 310 - 377 -3103
E-mail: mehr@mehr.org
URL:    http://mehr.org