PSR Sacramento

Physicians for Social Responsibility
Sacramento Chapter

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Join/Donate/Scholarship Dinner Payment

YES! I want to participate in PSR's work
to protect human health and the environment.
Prefix:
Dr. Mr. Mrs. Ms. Miss
First Name:
Last Name:
Suffix:
Address:

City:
State:
Zip:
Home Phone:
( ) -
Work Phone:
( ) -
E-mail:
Dinner Guests:
Membership:
  Sponsoring Member (Physicians & other health professionals w/ doctoral degrees)
$125
  Supporting Member (Residents, Interns, Nurses, other health professionals, concerned citizens)
$50
  Retired Member
$35
  Student Member
$15
General Donation Amount
$
Directed Scholarship Fund Donation Amount
$
Payment for April 27, 2014 Scholarship Dinner:
  Number of General Reservations ($35 per person)
  Number of Student Reservations ($20 per student)
Number of vegetarian dinners (if applicable)

 

PSR/Sacramento is a 501(c)(3) non-profit organization. Membership payments and donations are tax-deductible.

I will submit payment:



 

Nuclear Weapons and Militarism | Environmental Work | Gun Violence Prevention | Universal Health Care

Home | Join PSR | Donations | Our Work | Scholarship Essay Contest
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PSR is the U.S. affiliate of International Physicians for the
Prevention of Nuclear War, winner of the 1985 Nobel Peace Prize

The Sacramento/Davis Area Chapter of Physicians for Social Responsibility
10 Dumfries Court
Sacramento, CA 95831
916-955-6333
info@sacpsr.org