Join the Chronic Illness Coalition
Membership Rates
New rates effective January 2008: $25 per person, per year.
Walk in: $5 per meeting.
Benefits of Membership
If you are interested in joining or renewing membership to the Chronic Illness Coalition,
please complete the following and return with your check or money order made payable to:
Chronic Illness Coalition. Mail to: 21311 Civic Center Dr. 2nd Floor, Southfield, MI 48075.
Thank you for your interest and support.
_____Corporate _____Self Employed _____Non-Profit _____Individual
Name (include professional affiliation i.e. RN MSW):
________________________________________________________________________
Address _________________________________________________________________
City____________________________ State: __________ ZIP: _________
For Web Listing:
Website __________________________________________________________________
Brief one line description your business: ________________________________________
________________________________________________________________________
Phone ______________________________ Fax ________________________________
Email ______________________________ Type of Business: _____________________
Membership Rates
New rates effective January 2008: $25 per person, per year.
Walk in: $5 per meeting.
Benefits of Membership
- website listing
- networking
- free booth at any C.I.C. Project: Insure the Uninsured event (based on available space)
- Group rate discounted LTC Insurance
- 1 CEU per General Meeting for RNs
- possible funding resources for your in-need clients
- information resources
If you are interested in joining or renewing membership to the Chronic Illness Coalition,
please complete the following and return with your check or money order made payable to:
Chronic Illness Coalition. Mail to: 21311 Civic Center Dr. 2nd Floor, Southfield, MI 48075.
Thank you for your interest and support.
_____Corporate _____Self Employed _____Non-Profit _____Individual
Name (include professional affiliation i.e. RN MSW):
________________________________________________________________________
Address _________________________________________________________________
City____________________________ State: __________ ZIP: _________
For Web Listing:
Website __________________________________________________________________
Brief one line description your business: ________________________________________
________________________________________________________________________
Phone ______________________________ Fax ________________________________
Email ______________________________ Type of Business: _____________________
The Chronic Illness Coalition
21311 Civic Center Dr., 2nd Fl
Southfield, MI 48075
1-800-905-8862
21311 Civic Center Dr., 2nd Fl
Southfield, MI 48075
1-800-905-8862
