FEAT of Oregon
Membership

FEAT of Oregon
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Inclusion of information about Autism organizations, providers, publications, services, programs and products on our web site does NOT constitute any agreement, sponsorship, endorsement or warranty of any kind by the FEAT of Oregon.

Membership Form

To Register, print, fill out, and return the form to the address below:

Name(s):
_______________________________________________
I am a: ____Parent ____Professional ____Relative ____Friend
Organization: _______________________________________________
Address:
_______________________________________________
City, State Zip:
_______________________________________________
Phone:
_______________________________________________
Email:
_______________________________________________
Membership/Donation amount (per family/household):
 

_____ $10
_____ $25 *
_____ $50
_____ $100
_____ other _____________

* Please donate at this level if you can, but any amount is appreciated.

Visa/MC#:
_______________________________________________
Name on Card:
_______________________________________________
Card Billing Addr, City, State, Zip:
_______________________________________________
 
_______________________________________________
Expiration Date:
_______________________________________________
Signature:
_______________________________________________

Please check one or more of the following:

_____ I want to be on the feator email list. To qualify for membership on the list, you have to [1] be a parent or relative of a child with autism [2] attend a FEAT function and tell us something about yourself OR if you can’t make it to a meeting, send an email with some information about yourself to:

_____ Add my name, address, email, and phone number to the membership list available only to members

Please provide Visa/Mastercard information or enclose appropriate FEAT Membership dues payable to FEAT of Oregon along with this form to: