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YES! I want to support normal birth and enjoy
the benefits of ICAN membership!
o $30 Basic Subscriber (1 year)
In addition to receiving ICAN's newsletter, the Clarion, you will be supporting an all-volunteer international
organization, which educates families in need of birth, cesarean, and VBAC information. Basic Subscribers in
Colorado can also add a listing on our local Directory of Birth Professionals.
o
$80 Professional Subscriber*
(1 year)
Includes all of the benefits of Basic Subscription PLUS a listing on ICAN's national
Professional Subscriber Network. ICAN's national website receive 4000 to 5000 hits per month,
so this is an excellent marketing tool for professionals who work with and support childbearing families.
* Professional Subscription applicants MUST print out and send in the application packet with this form
and their payment. Click HERE for more information and a printable application packet.
o $150 Childbearing Years Member (5 year subscription)
o
$300 Childbearing Years Member (10 year subscription)
o
$500
and up Lifetime Subscriber
o $ _______ Additional donations are welcome, needed, and tax deductible! (see receipt below)
Thank you for your support!
Please make checks payable to ICAN of Colorado
3449 Eliot Street, Denver, CO 80211
Member Information
Name: _____________________________________________ Date: ______________________
Address: ______________________________________________________________________________
City: ____________________________________ State: _______ __ Zip: ________________
Phone: ( ) ___________________ Email: ________________________________________
Receipt for Charitable Donation
Name: ___________________________________________ Date: ____________________
Amount of Donation: $ ________________ ICAN of Colorado Tax ID # 061241254