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Annual Subscription Form

Back to: Issue No.34


The INFLAMMATORY NEUROPATHY SUPPORT GROUP OF VICTORIA INC.

Supporting sufferers from acute Guillain-Barré Syndrome (GBS) and
Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

YES, I am happy to continue helping the IN Group by renewing my membership.

I Enclose $.......... being Annual Subscription $10 and optional donation. Subscription is due on the 1st of July each year.

Cheques should be made out to The IN Group and mailed to:

The Secretary,
The IN Group
138 B Princess Street
Kew 3101

You can print this web page in your web browser and mail the completed form below - Webmaster


ANNUAL SUBSCRIPTION
Name ................................................
Address .............................................
        .............................................
        ............................................. Post Code ..........
Telephone (Home) .........................
Telephone (Work) .........................
Signed ...................................
Date .....................................


Thank you


Last Updated: 03 May 2003 14:07