EOL Coalitions Membership Registration
2008 Membership Benefits:
The Carolinas Center for Hospice and End of Life Care supports and promotes access to quality palliative care through the end of life.
Consultation and technical assistance by phone and e-mail
Suggested resources for your strategic planning and community engagement including participation in the
L
earn
I
mplement
V
oice
E
ngage activities in each state
Workshops and conferences specifically tailored to local end of life coalitions, hospice and
Respecting Choices
®
instructors
Member discounts on conference and workshop registrations
Two newsletters: Periodic e-newsletter about end of life issues, coalition news, local and national events; plus a subscription to The
Weekly Update
, a newsletter that reports on current events, research trends, and important national developments in the end of life care movement
Opportunity for networking with other coalition leaders, hospices and
Respecting Choices
®
instructors in LIVE NC and LIVE SC
Member discounts on purchases of all Advance Care Planning consumer materials published by The Carolinas Center
Primary Contact (first and last name)
Coalition
Organization
Mailing Address
Street Address
City
State
Alabama
Alaska
Arizona
Arkansas
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Colorado
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Delaware
D.C.
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Kentucky
Louisiana
Maine
Maryland
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Nevada
New Hampshire
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New Mexico
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Ohio
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Rhode Island
South Carolina
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Tennessee
Texas
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Vermont
Virginia
Washington
West Virginia
Wisconsin
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Zip Code
Phone Number
Fax
Email Address
Website Address
Membership Dues are $250
Credit Card
Visa
Master Card
Credit Card Number
Expiration Date
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