Join Us!

Thank you for renewing your membership to our international organization!

Your tax-deductible donation will support our web site, online support groups and discussion forums, CHD Awareness Day efforts, Newsletter, and services to organizations and support groups throughout the world.

Once we receive your completed form, we will send you either an email message or postcard that will serve as your receipt.

For residents of the United States, a portion of the annual membership is tax-deductible:

Type

Annual Dues

Tax Deduction

Individual/Family $ 20
$ 15

Donor $ 50
$ 45

Sponsor $100
$ 95

Benefactor $250
$ 245

Donations without membership, and memorials or tributes are also welcome. Click here for more information.

Please click here if you are joining for the first time rather than renewing an existing membership

Individual/Family Membership Renewal

(click here for the Professional Membership Renewal Application)

If you are not renewing but joining us for the first time,
please use the Family Membership Application

If you have any questions or need help with the medical information on your form, please feel free to contact us either by phone or email.

Please use the Tab key to move between the fields. Press the Enter key or click the Submit button when you are ready to submit the form.

Please contact us if you would like to become a member and would like to request a waiver of the membership fees. We will promptly consider all requests for assistance.

I wish to renew my
membership at this level

$20 Individual / Family
$50 Donor
$100 Sponsor
$250 Benefactor

Other: $

Please tell us about yourself...

We take the privacy of our members very seriously, and will not share the information that you submit below with anyone without your explicit prior permission. Please click here to see our complete privacy policy. (Another window will open so you will not lose your place).

First Name

Last Name

Mailing Address

City

State/Province

Zip/Postal Code

Country

Day Phone

Evening Phone

Please provide your email address below or enter "None" if you don't have an email address. We will use this address to contact you, and this is the address that will be authorized to subscribe to our members-only support and information lists. Please double-check your entry to make sure it is correct.

Email Address

Suggestions and Comments (Optional)

(Comments can also be mailed to mb@tchin.org)

Summary

Your contact and personal information will be kept strictly confidential, and will not be shared with anyone without your express written or electronic permission. Should you wish to participate in a local networking system with other C.H.I.N. members, please check the consent below.

	I hereby authorize C.H.I.N. to release my name and email address to other members in my state for purposes of informal interaction, support and information sharing, or event planning. I understand I can revoke this permission at any time.
	*Please keep my information private.*

Once you submit this form, you will be taken to a confirmation page, where you will be given the option to contribute securely online with a credit card, or by mail.

Thank you again for your support!

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with this form to <sysadmin@tchin.org>}

Donations without Membership

If you would like to support our organization and Congenital Heart Defect Awareness Day without joining, you can make a one-time tax-deductible donation securely with a credit card or check. Be assured that we respect your privacy and do not share information about our donors or members with anyone.

Click the banner on the right to help support our organization!

Click for more...

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Online Support	Pins & Brochures	For Families	Financial Support
Memorial Garden	Resource Room	For Nurses	Help Wanted
Portrait Gallery	Support Groups	For Professionals	Our Volunteers




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	Disclaimer: The contents of this site are presented for informational purposes only, and should not be substituted for professional advice. Always consult your (child's) physicians with your questions and concerns. Created and maintained by Mona Barmash and Uwe Baemayr for The Congenital Heart Information Network. Exempt organization under Section 501(c)3 Copyright �1996 - 2008 C.H.I.N. all rights reserved TX4-390-685