Membership Form

Chemical Injury Information Network
PO Box 301 White Sulphur Springs, MT 59645
406.547.2255

Members' donations are 100% tax deductible.

To become a member of CIIN and receive Our Toxic Times, please use one of the links at the bottom of this page to use our secure server or print the new member form and return it with your tax-deductible donation in any amount to: CIIN, PO Box 301, White Sulphur Springs, MT 59645 USA. Each donation by credit card must be at least $25.

A yearly donation is necessary to become and to stay a member of the Chemical Injury Information Network. CIIN’s activities are almost exclusively supported by your donations.

To make a donation, go to the Membership Form page (ciin.org/member_online.html); or call (406) 547-2255 to donate by MasterCard, Discover or Visa; or mail in a donation in any amount. (Suggested donations are: Fixed income – $15; Employed individuals – $30; Professionals – $50.) If you can donate more, that will be greatly appreciated; if you need to donate less, we still welcome you. In any event, please join CIIN.

Gift memberships are a minimum of $25.

Our requirements are different for foreign members who want to receive a paper copy of the newsletter: Donations must be at least enough to cover the cost of postage. For Canada and Mexico that is $19, and for the rest of the world that is $30.

A donation in any amount will reinstate membership, however, less than $25 will restart the newsletter beginning with the next month’s issue, not with the current issue.

Sign up via our secure server (Preferred method)

Printable version