HeadWise HeadWise: Volume 4, Issue 4 - Page 31

Your Contributions to the National Headache Foundation Help Fund Projects What’s being done to help your headache problem? There is an unprecedented amount of research being undertaken regarding migraine and other headache pain. The National Headache Foundation is involved in this effort with the help of funding from you. Contributions are a key part of the financial support of important headache research. Your gift provides funds for (a) NHF-financed research projects, (b) advocacy with health policy decision makers, and (c) patient-education initiatives. You can help! The National Headache Foundation, the #1 source for headache help, provides these services and many others through the generosity of people like you. Please select one of the following giving categories: ❒ $250 ❒ $125 ❒ $100 ❒ $75 ❒ Other _________________ Name: _______________________________________________ Address: _____________________________________________ City: _________________________________________________ State/Zip: ____________________________________________ Daytime Phone: ________________________________________ Method of Payment: Check or Money Order payable to National Headache Foundation ❒ Visa ❒ MasterCard ❒ Amex ❒ Discover Card #: _____________________ Expiration Date: ___________ New Membership | Toll-Free (888) NHF-5552 | www.headaches.org Payment: Individual Membership:  $20.00 to receive HeadWise® plus the monthly e-newsletter, NHF News to Know,  Payment enclosed (check payable to National Headache Foundation) when you join the National Headache Foundation In addition, I’d like to make a tax-deductible contribution in support of NHF’s educational programs in the amount of:  $10  $25  $50  Other: $_____ Charge to my credit card:  Amex  Discover  Mastercard _______________________________________________________________ Name (Please Print) ___________________________________________________________ Credit Card Number Expiration Date _______________________________________________________________ Address ___________________________________________________________ Cardholder’s Signature _______________________________________________________________ City/State/Zip/Country ___________________________________________________________ Billing Address (If different from mailing address) _______________________________________________________________ Preferred Phone # E-mail Address ___________________________________________________________ City/State/Zip/Country  Visa Please mail this form with your payment to: National Headache Foundation, 820 N. Orleans, Ste. 411, Chicago, IL 60610 or renew online by visting www.headaches.org www.headaches.org | National Headache Foundation 31