HEIR Donations, Membership Subscription Form

Help Keep
Freedom in Education

Join HEIR

http://www.heir.org

Check each that applies:

I wish to renew my membership to HEIR and I understand that unless I request otherwise, I will be included in an e-directory available only to members

$12 per family

$_____

I wish to become a member to support HEIR's volunteer efforts and I understand that unless I request otherwise, I will be included in an e-directory available only to members

$12 per family

$_____

I wish to volunteer to contact other HEIR members by telephone for Legislative Alerts, etc.

I wish to volunteer to work the HEIR booth at events in my area (usually complimentary admission)

I am including an additional donation

Donation Amount

$_____

Total Enclosed (HEIR is a 501c4 civic league - donations are not tax-deductible):

Name
Street Address
City	State	Zipcode
E-mail		County
Phone (10-digit)		FAX (optional - for directory)
Years of Kids' Birth (optional - for directory)
Comment (optional - for directory)
GA House District (optional)	To find your district numbers check your voter registration card or look them up on the web at http://www.vote-smart.org, www.congress.org or call Senate Public Information Office at 404-656-5082
GA Senate District (optional)
US House District (optional)
Please fill out any information that might have changed

Mail above with check to: HEIR, P.O. Box 1128, Tucker, GA 30085-1128.