Application for Membership|
We hope you will join Hemlock Society of San Diego.
Please print this page (click FILE-PRINT) and send it with your check made out to HSSD to the following address:
PO Box 34237
San Diego, CA 92163
Hemlock Society of San Diego
A non-profit tax-exempt 501 (c)(4) independent organization
Individual ______ $25 Couple ______ $40
Individual ______ $250 Couple ______ $400
____ I would also like to support HSSD with an additional donation of $_________.
____ I may be interested in including HSSD in my Will or Trust. Please contact me to discuss this further.
City: ___________________________ State: _____ Zip: ________________
Phone: ________________________ Email: __________________________
Comments (optional): _____________________________________________