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Become a MemberIf you work for an AIDS-related, not-for-profit, community-based organization in the New York Metro Area, then your organization is eligible for membership in the HIV/AIDS Information Outreach Project. Please print out the form below, complete it, and then fax it to (212) 423-0266, OR mail it to the HIV/AIDS Information Outreach Project, The New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029.
Community-Based Organization (CBO) Registration FormPlease provide the names, phone numbers and e-mail addresses of all persons in the organization that may use this service. You may attach additional pages if necessary.) name: _____________________ phone:_____________ e-mail:________________ name: _____________________ phone:_____________ e-mail:________________ name: _____________________ phone:_____________ e-mail:________________ Does your organization currently have a Web site? Yes__ No__ If not, are you interested in having the Outreach design and host a site for you? If yes, please provide the address below. CBO’s Web Address: _____________________________________________ Please describe the services that your CBO provides to communities
affected by HIV and AIDS. (Please attach additional pages if
necessary.) ____________________________________________________________________________ If you have questions or need more information please call the Outreach at (212) 822-7323. |
This Website was
founded and is maintained in conjunction with
The New York Academy of Medicine's HIV/AIDS
Information Outreach Program.
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HIV/AIDS Information
Outreach Project The New York Academy Of Medicine 1216 Fifth Avenue New York, NY 10029-5293 Phone: (212) 822-7323 Fax: (212) 423-0266 Email: hivinfo@mail.nyam.org Last Update:06/08/01 Directions to the Academy © 1999 |
