Register Minerva Friends

by

Thank you for
registering as
Minerva Center Friend
Your support is appreciated.
Your contribution is tax deductible.

 

Please enter your name, address, phone numbers and personal listing information below.
When you have checked your information and are satisfied,
click the Submit bar at the bottom of the form.
 

Last Name



First Name

Address


Address 2


City

State

Zip/Postal Code

Country

E-Mail Address

Home Phone

 (optional)

Work Phone

 (optional)

FAX

 (optional)

 Register on Friends Roster (minimum donation $100/year)
 Register on Friends Roster and create Web Page (minimum donation $250/year)

Amount of donation 

You may fax your credit card payment (Visa or MasterCard) to
Debra E. Morgenstern at 914-693-2834
or send your check to
The MINERVA Center, Inc.
20 Granada Road
Pasadena, MD 21122
Be sure to mention your donation is for registration on the Minerva Friends Roster
Donations to The MINERVA Center, Inc. are tax deductible
 

Use this space to write the text (up to 100 words) you wish to appear under your name on
The Minerva Friends Roster
Use the Return key to mark the end of each line of text.
In this space insert two or three words defining your entry,
e.g. “World War II WAC” or “Physical Therapist”
If you have selected the Friends Roster with Web Page option, send e-mail to Linda Grant De Pauw describing approximately what you would like and enclosing the text you want to use.
If you do not have an e-mail account, telephone 410-437-5379 or fax 914-693-2834.

Your web page may include whatever you like, a description of your business, your service record, autobiographical essays, links to other web sites, and links to your e-mail address.
If you have published a book, I can link your page to Minerva’s Bookstore page so it can be ordered through Amazon.com. I can include photographs, logos or other graphics you provide. Or I can use clip art from my collection.

You will be able to view your page on the web before it is linked to the Minerva Center site and request changes. You may also make reasonable revisions in the future at no cost.

 

Please check over this registration form, then click Submit
In a few moments you will receive confirmation of your submission
which you may wish to print out for your records
Thank you for supporting the Minerva Center.