Membership Application

Name              
Address          
City                      State           Zip 
Home Phone   

Membership Type:   Single  $20     Family  $30

Are you and/or your family a:
  Self-advocate             Parent/Relative
 Interested Citizen         Corporate Sponsor
  Professional in Developmental Disabilities field

 Are you/family member currently receiving services from The Arc?

 In a effort to know and serve our members better, please complete
  this questionnaire.  All answers are kept confidential.

  Applicant's profession:
  Company:                  
  Business address:       
  City / State:                
  Business phone:          
 
  Please address all correspondence to my:
   home                               business

   I / We belong to the following club / service organizations:
  Kiwanis              Knights of Columbus
  Lions                  Masons               Rotary
  Elks                    Other:  

   I would like to work with The Arc/Morris.  Please send me
        information about volunteer opportunities. 
       Or call 973.326.9750 x 211.

      Thank you.  Your membership makes the difference.  As a
      member of The Arc/Morris you will receive the county,
      state and national newsletters.   

      Please mail check or money order for membership fee to:
      The Arc/Morris, PO Box 123, Morris Plains, NJ 07950-0123