UNITED AMPUTEE SERVICES ASSOCIATION
2003 MEMBERSHIP FORM

PLEASE HELP US HELP OTHERS

The United Amputee Services Association (UASA) is a non-profit (IRS 501c-3) dedicated to helping amputees across the nation live a fulfilling life with dignity and independence. The association was chosen by the Barr Foundation to implement and run the Barr/United Amputee Assistance Fund (BUAAF). A major thrust of BUAAF is providing financial assistance to amputees that have no other source of funding. We deeply appreciate any donations you are able to make so that we may continue to help others.

If you wish to become a supporting member of U.A.S.A., please fill out and submit the form below, and mail your tax deductible contribution to U.A.S.A., P.O. Box 4277, Winter Park, FL 32793-4277.

Sincerely,

Jim Moore
President
United Amputee Services Association, Inc.

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