Name:  __________________________________________________________________________

Street:   __________________________________________________________________________

City:      __________________________________________________________________________

State:    __________________________________________________________________________

Zip Code:  _______________________________________________________________________

Telephone:  (____)_________________________________________________________________

e-mail address: (please print clearly)

___________________________________________________________________

Would you like to receive the NLHS newsletter via e-mail? (_____YES ______NO)

If you mark YES, you will receive a notice each month when the newsletter is ready to be downloaded as a PDF file from our website. You would be able to read it right in your browser windor or save it to your own computer to read and print later. You would also be added to a special e-mail list and receive announcements of news, events and programs that occur between newsleters.

If you mark NO, you will receive the newsletter via regular postal mail.

 Please print and fill out this form.  Send it, along with a check or money order for $20.00 ($25.00 outside the U.S.) to:
                          Special offer for new members only: sign-up for 2 years at $35 ($45 outside of U.S.)