We invite you to join
The Foundation for Mind-Being Research.

This form may be filled in online, printed, and mailed along with your check to the address below

First Name:

Last Name:

Home Phone:

Office Phone:



City:     State/Province:     Postal Code:


I hereby apply for: FMBR Membership prorated to $40. ( includes spouse)
( Your membership is good thru August of this year.)

                (A full year of FMBR membership is $60.)

Please make check payable to FMBR and write membership - Web on the memo line. Send check and completed form to:

       PO Box 449
       Los Altos, CA 94023-0449  

If you have questions click here to contact us.

[ FMBR operates as a non-profit scientific research organization under the laws
of the State of California under IRS code 501(a)2 with tax exempt status under Section 501(c)3.]

Updated August 21, 2015.