Huntingdon Pennsylvania Yoga Massage Health Wellness

Membership Application For Fiscal Year Oct. 1, 2011 to Sept. 30, 2012

Huntingdon Health and Wellness Association (HHWA)

 

 

Name___________________________________________________________________________________________________________________

 

Business Address (if applicable) ______________________________________________________________________________________________

 

 

Street Address____________________________________________________________________________________________________________

 

 

P. O. Box________________________________________________________________________________________________________________

 

 

City__________________________________________________State________________Zip___________________________________________

 

 

Phone_____________________________________________________Fax_________________________________________________________

 

 

E-mail__________________________________________________________________Web Address ____________________________________

 

 

 

Type of Business (if applicable)_____________________________________________________________________________________________

Date ______________________________________________________

 

If you have a wellness related business or service, please provide a 75-word or less description as you would like it
to appear in membership brochure, publicity, etc. (NEW member or NEW information only)

 

 

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Please include the $25 membership fee payable to Huntingdon Health and Wellness Association.
Mail to Jennifer Breimhurst, Treasurer  313 Fourth Street, Huntingdon, PA 16652.