65 East Young St • Somerville, NJ 08876-0233 | 609.510.9039 | info@ananj.org

Search Our Site

Acoustic Neuroma Association of New Jersey
ANA/NJ Inc.
65 East Young St Somerville, NJ 08876-0233
Phone: 609.510.9039
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________  

Membership/Donation 

 Thank you for thinking of joining ANA/NJ and/or for making a donation to support the work of our organization! Please complete the Membership/Donation form provided below and send it along with your check to: ANA/NJ Inc., c/o Jane Huck, 65 Young Street, Somerville, NJ 08876. Or contact Jane at 908-725-0233; email This email address is being protected from spambots. You need JavaScript enabled to view it..           

Membership/Donation Form 

          Name_________________________________________________________________________________________________      

          Address______________________________________________________________________________________________

          City ______________________________________________ State ____________________Zip _____________________

          Phone (            )   ________________________   E-mail  _______________________________@ ________________    

 

              Membership Categories                                                      Contribution Categories                                                                                                                                                 

           Annual Membership  . . . . . . . . . . . .  $  25                                     □   Sponsor a member  . . .  . $25 . . . . . . . □  Supporter      $50-$200

          □ Life Membership . . . . . . . . . . . . . . .   $200                                     □  Associate  . . . . . . . . . . .   $10 – $50 . . □  Benefactor    $200 & above                                                                                       

  Membership dues and gifts are the main resources                                     A gift in honor of:       □   A gift in memory of:      

available to ANA/NJ to help us fulfill our  mission to

provide information, encouragement, and support to AN                           Name ______________________________________________     

patients and their families.   Please consider supporting 

 ANA/NJ’s endeavors by becoming a member or                                                                 Please send an acknowledgement to:

 contributor. Thank you!

                                                                                                                                 Name  ______________________________________________

                                                                                                      

                                                                                                                                Address ______________________________________________

 

                                                                                                                               City___________________________State_______Zip__________

 

  Please make all checks payable to:            All members will receive the news-                                         For membership in ANAUSA:

  ANA/NJ                                                       letter, notices of local meetings, updates,                                   Acoustic Neuroma Association

 65 East Young St                                         pamphlets & other information.                                                  600 Peachtree Pkwy, Suite 108

Somerville, NJ 08876-0233                                                                                                                                      Cumming, GA  30041                 

 

 

____________________________________________________________________________

 

                                                                                     

Thank you for thinking of joining ANA/NJ and/or for making a donation to support the work of our organization. Membership dues and gifts are the main resources available to ANA/NJ to help us fulfill our mission to provide information, encouragement, and support to AN patients and their families. Please consider supporting ANA/NJ’s endeavors by becoming a member or contributor. Thank you!

Please print this page and send along with your check to:

Jane Huck, Treasurer
ANA/NJ, Inc.
65 E. Young Street
Somerville, NJ 08876

Would you like to give a gift or a donation? Donation cards are available to honor or in memory of someone special.

Email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 908.725.0233.

Executive Board

Wilma Ruskin
President

David Belonger
Vice President

Jane Huck
Treasurer

Richard Barker
Secretary

Donna Carides

Kathy Cecere

Gaby Hecht

Medical Advisory Board

Richard M. Hodosh, MD
Summit, NJ
Neurosurgery

Scott L. Kay, MD
Princeton, NJ
Otolaryngology/Facial Plastic Surgery

Jed A. Kwartler, MD
Berkeley Heights, NJ
Otology/Neurotology

John D. Lipani, MD, Ph.D.
Hamilton, NJ
Neurosurgery/Stereotactic Radiosurgery

James K. Liu, MD
Newark, NJ
Neurosurgery/Skull Base Surgery

Michael L. Rosenberg, MD
Edison, NJ
Neurology/Neuro-Ophthalmology

Samuel Selesnick, MD
New York, NY
Otorhinolaryngology

Legal Counsel

Philip D. Stern, Esq