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Membership Application
Name:
Title:
Organization:
Address:
City:
State:
Zip:
Phone:
Email:
Individual:
$15/Year
Individual:
$70/5 Years
Organization Partners:
$40/Year
Organization Partners:
$170/5 Years
Corporate Partners:
$100 min/Year
Corporate Partners:
$450 min/5 Years
Student:
$5/Year
Payment Options
Credit card/PayPal
Make check payable & mail to:
Utah Breastfeeding Coalition
P.O. Box 16599
Salt Lake City, Utah 84116-0599