home
fall 2009 president's message
spring 2009 president's message
chapter
about us
our board
dr stamey
dr drasby
president
first vp
second vp
third vp
treasurer
support
about parkinson's
parkinson's treatment
Information & Referral Center
Educational Classes
groups
augusta
bangor
biddeford
blue hill
brunswick
camden
cape elizabeth
falmouth
falmouth yoga
lewiston
norway
south portland
yarmouth
york
waterville
E V E N T S
Lake Region Parkinson's Support Group 'Walk-A-Thon' 2K, 4K
J O I N
Join Online
download application
D O N A T E
please help
download donation form
news
breaking news
fall/winter 2009 newsletter
spring 2009 newsletter
contact
email us
facebook
links
Membership Form
Fill-out the online form below, click [submit], and pay your membership fees through Paypal.
I am a...
New Member
Renewing Member
Name
Address
City
State
Zip Code
Phone
Email
Do you have skills, time or other resources you would be willing to contribute to the Chapter?
Leadership/Chapter Board Membership
Event Coordinator
Media
Outreach
Volunteer
Website Maintenance
Advocacy
Other
If "Other" please state
How do you prefer to receive information or other communications?
Print Publications
Email/Internet
Select Individual or Household Membership
Individual Membership $25
Includes ~ Admission to the Annual Awareness Conference AND Discounts at Selected Maine Chapter APDA Events
$40 Household Membership
Includes ~ Same as Individual Membership plus one additional admission to the Annual Parkinson's Awareness Conference
If you would like to make an additional donation, please enter it here.
Once you submit the form, you will be directed to Paypal to complete your membership.