SAGE-USA CLUB MEMBERSHIP
REPLY FORM
Date:_________________________ Member Donation Amount:_________________
Full Name______________________________________________________________
Full Address____________________________________________________________
City, State & Zip________________________________________________________
Telephone:_____________________________FAX:____________________________
Email Address(s)___________________________________________________________
Company Name?_________________________________________________________
Your Signature:__________________________________________________________
Method of Membership Payment: __________________________________________
Any donation you care to make is welcome. Attach your signed check and fax it to SAGE-USA
Club Membership Officer – Barbara Ayash President using our
Toll Free Fax line: 800-826-5412.
Credit Card Membership payments are also accepted:
Check your card of choice: Amex Visa or Master Card
If you have any questions, please call 800-455-0173 or
Email our Membership Officer using the following email address:
baayash@earthlink.net
Sincerely yours,
Barbara Ayash – SAGE-USA Club Membership Office: