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Join The Guild of St. Francis Hospital Foundation Y es, I would like to become a Guild member. Please register me: Name Address
The Guild of St. Francis Hospital Foundation
City, State, Zip Telephone Email
Annual dues: Payment of $25
Membership information
Payment of $30 to cover myself and 1 person at the same address Lifetime membership of $200 Payment total $
Check. Please make checks payable to The Guild of St. Francis Hospital Foundation and return with this form to: Membership Chair The Guild of St. Francis Hospital Foundation 100 Port Washington Boulevard Roslyn, NY 11576 Visa Mastercard Amex If paying by card, please include complete billing address and zip code if different than above. Billing address City, State, Zip Card number Signature
Expiration
The Guild of St. Francis Hospital Foundation 100 Port Washington Boulevard Roslyn, NY 11576
Payment method:
chsli.org/st-francis-hospital