Become part of our network ......

please complete the form below and click   SUBMIT  

Yes! Please keep me informed


  

Please check if you already receive e-mailings from Second Journey.
Title First Name Middle Name/Initial Last Name Suffix Nick Name

Email           
Information below is optional

Address Line 1

Address Line 2

City           State           Zip Code   

Phone    Organization   

Please tell us which programs interest you:

Keep me informed about Second Journey's book publishing event:
The Making of an Elder Culture by Theodore Roszak

I wish to HELP with the ROSZAK PROJECT
Use the COMMENTS box below to share your ideas

Keep me informed about upcoming programs related to
Spirituality in Later Life

Keep me informed about upcoming
Spring 2009 programs in North Carolina and Virginia
Yes! I want to make a contribution
   to support the work of Second Journey

We welcome contributions at all levels. The categories below are used to acknowledge gifts.

Friend
Under $250

Patron
 $250

Partner
$500 		Benefactor
$1,000 		Other
Describe in  Comment box

Note: the Amount field below requires input; if you cannot make a contribution, please enter zero.
If you make an online contribution, you will still need to re-enter the amount below

Level of Contribution 

Amount:  

Under what name do you wish
your contribution acknowledged?

 
  Keep my gift anonymous

If you wish your gift confirmed by mail, please complete the address information above.

I want my gift to support:

Itineraries, the Second Journey e-Newsletter

The publication of  The Making of an Elder Culture by Theodore Roszak

A scholarship fund for Second Journey's programs

General operations
 

Comments?

 
 

 Please press SUBMIT below to review your information
and, if you are making a contribution, select a form of payment.

 

 

Second Journey, Inc.
4 Wellesley Place, Chapel Hill, NC 27517
(919) 403-0432

  

Second Journey, Inc. is a 501(c)(3) tax-exempt nonprofit corporation