Membership Application Form

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Funeral Consumers Alliance of Western Massachusetts
Print & Mail Application Form
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____Please enroll me in the Funeral Consumers Alliance of Western Massachusetts and send me the “Before I Go” End-of-Life Planning Kit and membership packet.  I am enclosing the suggested membership donation of $30.

 ____Please enroll me in FCAWM and send me the “Before I Go” End-of-Life Planning Kit and membership packet.  I am a person of limited means, and enclose a membership donation of  $________.

 ____I enclose an additional contribution to the FCAWM of $________ to help support its consumer education programs.

Name _________________________________________________

Address
_________________________________________________

City/State/Zip _________________________________________________

Daytime Phone
_________________________________________________

E-mail Address
_________________________________________________

How did you hear about FCAWM? ____________________________________

Make check or money order payable to FCAWM and mail to: 
Funeral Consumers Alliance of Western Massachusetts, P. O. Box 994, Greenfield, MA 01302-0994.

Please send me the following items with my membership packet*
___ Guide to Funeral Planning
___ Prepaying:  Benefits & Dangers
___ Cremation Explained
___ The Cremation Option in W. Massachusetts
___ Organ and Body Donation: A Gift to Science
___ Information on body donation to medical schools in Massachusetts
___ Complete list of FCA brochures available
*Your additional donation will help to cover our printing and postage costs.  Note that many of these brochures may also be downloaded from the website of our national office, http://www.funerals.org

Please send _____ additional “Before I Go” Planning Kit(s). 
I enclose a donation of $7.50 for each Kit ($10.00 for non-members). 

Please mail a  membership brochure to the following:
_______________________________________
_______________________________________
_______________________________________

If you would like to volunteer a few hours a month for office tasks or other services, please indicate your interest(s) and we will call you:
___Serve on the Board
___Price Survey Committee
___Newsletter Editor (with computer skills)
___Speakers Bureau (group presentations)
___Other: ___________________________

If you have any questions or you would like to invite an FCAWM speaker to make a presentation to your social organization or religious group, call us at (413) 774-2320 or send us an e-mail.via our website http://FuneralConsumersWMass.org