Join Friends of Altoona Regional Health System Today!

Please complete the information below, print the completed application, enclose it in an envelope with your membership fee and mail to:

Friends of Altoona Regional Health System
Altoona Hospital Campus Gift Shop
620 Howard Avenue
Altoona, PA 16601

For more information, please call (814) 889-7826.

Membership Categories: Annual Membership $5/year     Lifetime Membership $50 (one-time fee)
Name:
Address:
City:
State:
Zip:
Phone:
E-mail:
Date of Birth:
I am an employee of Altoona Regional
I am a retiree of Altoona Regional
Bon Secours/Mercy Altoona Hospital

Are you a School of Nursing graduate?
I was a graduate of Altoona Hospital SON
I was a graduate of Mercy Hospital SON

Please mark the box next to the committees on which you would most like to serve with a number. The number 1 (one) should indicate your first selection, 2 (two) your second selection, etc. You may mark as many boxes as you wish.

Auditing Committee
Baby Pictures Committee
Finance (Budget) Committee
Gift Shop Committee
Hospitality Committee
Nominating Committee
Program Committee
Scholarship Committee
Sewing Committee
Ways & Means Committee
Health Promotion Committee
Newsletter/Public Relations Committee
Legislative Affairs Committee



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