Huntington's Disease Society of America
Northeast Ohio Chapter

Please take this opportunity to become an active Partner in Progress through involvement and contribution. Help the Huntington's Disease Society of America shape the future of HD families.

Name _____________________________________

Address ___________________________________

City/State/Zip _____________________________

Telephone ________________________________

Email ____________________________________

Comments/Questions _______________________

_________________________________________
 

_________________________________________

Partners in Progress Contributions
__ New __ Renewal __ Address Change

Annual Membership

___ $15 Individual

___ $25 Family

Additional Contribution to fight HD

___$25 ___$50 ___$100 ___$500

___Other $______

Total Amount $ _____________
 

Please print this page and mail with your check to:

Barbara Kaiser – Development Director
HDSA Northeast Ohio Chapter
10176 Luman Lane
Twinsburg, OH 44087

 

Make checks payable to HDSA Northeast Ohio Chapter.

Contributions are tax deductible as provided by law.

To Donate Online: https://www.hdsa.org/neodonation.html

 

THANK YOU! The HDSA NE Ohio Chapter Board thanks all contributors and salutes medical advisors, scientists, the National Institutes of Health and all others who are PARTNERS IN PROGRESS.

Barbara Kaiser – Development Director
HDSA Northeast Ohio Chapter
10176 Luman Lane
Twinsburg, OH 44087
bkaiser@HDSA.org
Phone: 330-998-6600
Fax: 330-998-6677

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