HeadWise HeadWise: Volume 6, Issue 3 | Page 26

Your Contributions to the National Headache Foundation Help Fund Projects

What ’ s being done to help your headache problem ? There is an unprecedented amount of research being undertaken regarding migraine and other headache pain . The National Headache Foundation is involved in this effort with the help of funding from you . Contributions are a key part of the ��������������������������������������� research . Your gift provides funds for ������������ced research projects , ( b ) advocacy with health policy decision makers , and ( c ) patient-education initiatives . You can help ! The National Headache Foundation , the # 1 source for headache help , provides these services and many others through the generosity of people like you .
Please select one of the following giving categories :
�� $ 250 ����� $ 125 ����� $ 100 ����� $ 75 �����Other _________________
Name : _______________________________________________
Address : _____________________________________________
City : _________________________________________________
State / Zip : ____________________________________________
Daytime Phone :________________________________________ Method of Payment : Check or Money Order payable to National Headache Foundation � Visa �����MasterCard �������Amex �����Discover
Card #: _____________________ Expiration Date : ___________
New Membership | Toll-Free ( 888 ) NHF-5552 | www . headaches . org
Individual Membership : Payment :
�� $ 20.00 to receive HeadWise ® plus the monthly e-newsletter , NHF News to Know , when you join the National Headache Foundation
In addition , I ’ d like to make a tax-deductible contribution in support of NHF ’ s educational programs in the amount of : �� $ 10 �� $ 25 �� $ 50 ��Other : $_____
_______________________________________________________________ Name ( Please Print )
_______________________________________________________________ Address
_______________________________________________________________ City / State / Zip / Country
_______________________________________________________________ Preferred Phone # E-mail Address
��Payment enclosed ( check payable to National Headache Foundation )
Charge to my credit card : ��Amex ��Discover ��Mastercard ��Visa
___________________________________________________________ Credit Card Number
Expiration Date
___________________________________________________________ Cardholder ’ s Signature
___________________________________________________________ Billing Address ( If different from mailing address )
___________________________________________________________ City / State / Zip / Country
Please mail this form with your payment to : National Headache Foundation , 820 N . Orleans , Ste . 411 , Chicago , IL 60610 or renew online by visting www . headaches . org
26 HeadWise ® | Volume 6 , Issue 3 • 2017
170767 _ LOT A _ NHF Feb 2017 Vol . 6 Issue 3 . indd 26 2 / 15 / 17 12:48 AM