Application for Membership in DONE
To: DONE Members and Prospective Members
From: Shirley Moran, RN, MS
Treasurer
Re: 2009 Membership Dues
Please complete the form and bring to the next DONE meeting with your check or mail the form with a check
(made payable to DONE) in the amount of $50. Membership is $50.00 per year, due in January. New
members joining after July 1st will pay $25.00.
Please make your check out to DONE and mail to:
Shirley Moran
13 Andrea Road
Glendale
Newark, DE 19702
Do you want your name and e-mail address on the DONE Web site? Yes ___ No ___
Name:
Title:
Institution:
Preferred Mailing Address:
Work phone Home phone FAX
e-mail address
New member? AONE member? AONE membership #
Committee Interest: Legislative Membership
Education Nominating
Other interests or expertise?
Comments or suggestions?
***************************************************************************************************************************************
DONE USE ONLY:
Date Dues Paid ______________________
____________________________________
DONE Treasurer's Signature
Cash ___________ Check _____________
To: DONE Members and Prospective Members
From: Shirley Moran, RN, MS
Treasurer
Re: 2009 Membership Dues
Please complete the form and bring to the next DONE meeting with your check or mail the form with a check
(made payable to DONE) in the amount of $50. Membership is $50.00 per year, due in January. New
members joining after July 1st will pay $25.00.
Please make your check out to DONE and mail to:
Shirley Moran
13 Andrea Road
Glendale
Newark, DE 19702
Do you want your name and e-mail address on the DONE Web site? Yes ___ No ___
Name:
Title:
Institution:
Preferred Mailing Address:
Work phone Home phone FAX
e-mail address
New member? AONE member? AONE membership #
Committee Interest: Legislative Membership
Education Nominating
Other interests or expertise?
Comments or suggestions?
***************************************************************************************************************************************
DONE USE ONLY:
Date Dues Paid ______________________
____________________________________
DONE Treasurer's Signature
Cash ___________ Check _____________