End Abuse Long Beach
CHILD ABUSE & DOMESTIC VIOLENCE PREVENTION COUNCIL
P.O. BOX 1548, LONG BEACH, CA 90801-1548
Since 1975
www.EndAbuseLB.org

End Abuse Long Beach members receive e-mail announcements of monthly meetings and free CEUs for MFTs & LCSWs at eligible programs (per Approval #PCE 4131), as well as updates regarding upcoming workshops & conferences.  In spring 2009, all members will receive our annual Membership Directory.

To become a member, or to continue as one, please complete this form or attach a business card & return with a check for $30 ($5 for students) made payable to End Abuse Long Beach.  Mail to: P.O. Box 1548, Long Beach, CA 90801.

Or, register and pay online at wwww.EndAbuseLB.org.

Please fill in this form, print it, and mail it in with your check.

OR

Date:

Check One:   Renewal     New Member

PLEASE ENTER YOUR INFORMATION AS YOU WISH IT TO APPEAR
IN THE PRINTED DIRECTORY.
For the online directory, please make up your "Business Card" and email it to Paul@EndAbuseLB.org.

Please print clearly or attach business card.

Name Prefix:
Name:
Name Suffix:
Title/Position:
  Company Name:

Street:
   City: State:   Zip:
Work Phone:
     Fax:
    Cell:
Email:
Opt In Online Directory-PaidMembersOnly:
Company Description:

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For changes to your information please email Paul@EndAbuseLB.org