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Just print and fill our this form. You may either fax this form to +31.(0)40.2592.701
or mail it to any of the addresses provided on the below form.


DONATIONS &
NEW OR RENEWED SUBSCRIPTIONS


Name:


Address:



Current Membership Number:
(For renewals: Can be found above your name on the address label)

* Relationship to CF: (please check one)

I Have CF: My Child/Relative has CF: CF Doc/Nurse/etc: __ CF Association:__

Subscription to the Newsletter (4 issues per year) is £10 sterling, UK ($15.00 U.S.) or the equivalent in your own currency, plus any additional donation, if desired. To determine the exchange rate of your particular monetary currency either check the financial section of your newspaper, call your local bank or visit the following website: http://uk.finance.yahoo.com/m5?a=1&s=USD&t=GBP.

Subscription fee may be waived for CF adults or families facing financial stress.

Cost: CFW is a non-profit making organization which relies upon donations from CF charitable associations and subscriptions to the Newsletter. Each copy of the Newsletter costs the equivalent of approximately US$5 (GB£3) to produce.

Payment Methods: (Please select payment method 1, 2 or 3 below)

1. Wire Transfer:
Cystic Fibrosis Worldwide
210 Park Ave #267
Worcester, MA 01609
Account number 24 925725
Phone 1-508-733-6120

Bank information
Hudson Savings Bank
42 Main Street
Hudson, MA 01749
Routing number 211370529
Phone 1-978-526-2222

2. Checks Payable to: Cystic Fibrosis Worldwide
Send payment and form to: Christine Noke
210 Park AVE #267
Worcester, MA 01609 USA

3. Visa, Mastercard or Eurocard:

Subscribe online at http://www.cfww.org/SUBS.asp

Address Changes and Requests to stop mailing:
Please include the code number printed above your name on the address label.

By E-mail: subscriptions@cfww.org
By Snail-Mail: Christine Noke
210 Park AVE #267
Worcester, MA 01609
USA

* This information is not compulsory, but if completed will be helpful to colleagues working in the field of CF, for research purposes. Subscribers' identities will not be disclosed in this process. If you do not wish your information to be used in this way, please check this box ?