FIBROMYALGIA SOCIETY OF ONTARIO INC. RR # 1, Site 15, Box 10, Mindemoya ON P0P 1S0 Ph: (705) 377-4110  Fx: (705) 377-4110 Email: fibromyalgia_on@yahoo.com APPLICATION FOR MEMBERSHIP Receipt No: _____________ New: __________ Renewal: ________ Date: _________________ Membership Expiry Date: _____________________________________                                   Membership Fees:  $25.00       $__________________                                   Donations:                               $__________________                                   Other:                                      $__________________                                   Total:                                       $__________________ ( A receipt will be issued for income tax purposes ) Name: ________________________________________________________ Address: ______________________________________________________ City: ____________________________ Postal: _______________________ Phone: _____________________ Email: _____________________________ WHAT SERVICES ARE AVAILABLE TO MEMBERS? A quarterly newsletter second to none Helping in obtaining C.P.P. and other disability pensions Advocacy with various government agencies Referral list of physicians willing to treat FM/CFS/ME Referral list of lawyers specializing in disability cases Advice on medications and herbal remedies Coping skills