:: Sisters Network® Inc. ............ stop the silence

A National African American Breast Cancer

Survivorship Organization

Annual National Associate Membership Form

YES! I wish to improve the health of African American women today. By joining Sisters Network® Inc. you will receive the following benefits: national newsletter, membership certificate, and invitation to national events.

Three (3) Easy Ways To Join Sisters Network® IncInc.

	On-line: Use this secure on-line submission to join Sisters Network® Inc. by credit card only! Complete this form and click on Paynow. (credit card payment only)
	By Phone: 1-866-781-1808 between the hours of 10am and 5pm (CST), Monday-Friday. (credit card payment only)
	By Mail: click here for a printable version, print, and mail with payment (check, money order, or credit card) to Sisters Network® Inc., Associate Membership, 8787 Woodway Drive Suite 4206, Houston, TX 77063.

Please complete this form. * Required Fields.

Last Name:*		First Name:*
Address:*		Suite/Apt:
City:*		State:*
Zip:*		Country:*
Contact Number:*		Fax:
Web Address:		Email Address:

For your privacy, this information will be used solely by Sisters Network® Inc. and will not be shared with any other persons or organizations.