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, together with our annual calendar of programs, and updates regarding special workshops & conferences. In spring 2008, all members will receive our annual Membership Directory.

To become a member, or to continue as one, please complete this form, print it or attach a business card & return with a check for $30 ($5 for students) made payable to:

• End Abuse Long Beach
• P.O. Box 1548
• Long Beach, CA 90801

Date:

Check One: New Member Renewal

PLEASE ENTER YOUR INFORMATION AS YOU WISH IT TO APPEAR IN THE DIRECTORY.
Please write clearly or attach business card.

Name and Title:
Organization:

Street:
City: State:   Zip:
Work Telephone:
Work Fax:
Page/Cell phone:
Email Address: