To become a member of the Global Lawyers and Physicians network (non doctors or lawyers are welcome to join), please complete the form. As a member, you will be placed on our mailing list and will receive newsletters and updates on current projects and global concerns. We are in the process of developing a network of resources, of which you will be a part. The membership dues are as follows*:

Student $ 25.00 Member $ 95.00 Human Rights and Health Supporter $ 150.00 Human Rights and Health Sponsor $ 500.00 Human Rights and Health Benefactor $ 2,000.00

Please fill in the form and enclose your check or money order, and mail to:

Global Lawyers and Physicians, 715 Albany Street - T357W, Boston, MA 02118

Yes, I would like to join GLP:

Name:       _________________________

Address:    _________________________

City, State: _________________________

Zip:           _________________________

Telephone: _________________________

Fax:          _________________________

Email:       _________________________

Specialy (MD or JD)or occupation: _________________________

Affiliation:  ____________________________________________

Please sign me up as:

$25 Student Member

$95 Member

$150 Health and Human Rights Supporter

$500 Health and Human Rights Sponsor

$2000 Health and Human Rights Benefactor

Thank you for your support and membership.  

If you have any questions, or would like more information, please email [email protected]