Citizens for Long Term Care

 

Become a Member!

 

Our Principles

Independence
Choice
Role of Families
Access
Eligibility
Financing
Accountability
Standards
Coordination
Efficiency

Costs should
be spread
broadly and progressively, so that out of pocket costs are affordable.

 
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Membership Form
 Fill the form out, then print and fax to 202.737.4242
or mail to with membership payment to: Citizens For Long Term Care,
1001 Pennsylvania Ave., NW, Suite 850N, Washington, DC 20004

 

  

Our organization agrees with the Principles of Citizens for Long Term Care and wishes to join your effort. Please find our contribution below:

$1000 $2,500 $5,000 $7,500 $10,000 Other

 

As an individual I agree with the Principles of Citizens for Long Term Care and wish to join your effort. Please find my contribution below:

$100 $250 $500 $750 $1000 Other
Our organization agrees with the Principles of Citizens for Long Term Care and wishes to join your effort. We are unable to make a financial contribution, but we will serve as a member.
   

Organization/Individual's Name:
Contact's Name:
Address:
City:
State:
Zip Code:
Phone:
Fax:
Email:
Organization Web Site:
Date:

Signature:________________________________

Please print out form and sign.
Then fax to 202.737.4242
or mail to with membership payment to:
Citizens For Long Term Care
1001 Pennsylvania Ave., NW, Suite 850N
Washington, DC 20004