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 financial support of important headache research. Your gift provides funds for( a) NHF-financed 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: ___________
Subscription:
New Subscriber | Toll-Free( 888) NHF-5552 | www. headaches. org
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
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