Fresno Metro Ministry

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Name:

Organization, if any:

Phone:

Fax:

E-mail:

Mailing Address:

City: State: Zip Code:

Local Health Care Coalition

I am interested in participating in the Community Health Care Roundtables on the third Thursday of every month from 7:30 - 9:30 a.m.
Please reserve space for people at the next Roundtable.

I would like to receive the Roundtable information via:
E-mail
Mail (hard copy)

My organization would be interested in sponsoring a Roundtable.

I would like to suggest a Roundtable topic:

I am interested in participating in the following health program Action Teams:
Uninsured/Indigent

Insured Underserved

Community Health

Health Care Consumer Action Team

Fresno Metro Ministry

I am interested in participating in the Hunger and Nutrition Forums on the second Wednesday of every month from 12:00 - 1:30 p.m.
Please reserve space for people at the next Forum.

I would like to receive the Forum information via:
E-mail
Mail (hard copy)

My organization would be interested in sponsoring a future Forum

I would like to suggest a Forum topic:

I am interested in participating in the following hunger/nutrition program Action Teams, Committees and/or Task Forces:
Policy Action Team
Community Education and Advocacy Action Team
Food Program Inventory Task Force
Cultural Issues Action Team
Coordinating Committee
Low-Income Consumer Committee

I would like to receive the Fresno Area Opportunities for Health Care 2001 eligibility binder.
(Please call Fresno Metro Ministry at 559-485-1416 to arrange picking up a complementary copy/ies)

I am currently using the Opportunities for Health Care binder, and I would like to receive the most recent annual update inserts.
Number of insert packets needed

I would like to receive the most current Making Connections Community Resource Directory for a $7.00 donation, plus postage.
I will send a Purchase Order to Fresno Metro Ministry.
I would like to arrange picking up a directory at the Fresno Metro Ministry office.
I would like to arrange having a directory mailed or delivered to me.
Number of directories needed:

I would like to receive copies of A Multifaith Handbook.
(Please call Fresno Metro Ministry at 559-485-1416 to arrange picking up a copy/ies for a requested donation.)

I would like to be added to the mailing list to receive Fresno Metro Ministry's monthly newsletter.

I am interested in participating in one of the upcoming Cross Cultural Clusters sessions.
I am interested in being trained as a facilitator for the Cross Cultural Clusters sessions.

I would like to become involved in one or more of the task groups and committees at Fresno Metro Ministry.
Cross Cultural Clusters Steering Committee
Community Resource Directory Committee
Metro Newsletter Committee
Nominating Committee
Special Events Task Groups
Urban Tours

I would like to make Fresno Metro Ministry aware of an issue in the Fresno community (i.e. justice, rights, or service issues).

I would like more information about:

I would like to make a contribution to Fresno Metro Ministry.
Financial donation (Please send your check to the address below or donate online.)
Volunteer my time (We will contact you for more information.)
Offer meeting space (We will contact you for more information.)