OAUX Adult Membership Form 2024

Please complete the questionnaire below. Once you submit the form you will be directed to the payment screen. If you have any questions or concerns, please contact Jen at info@oaux.org or 908-522-2004.

Contact Information

Name *

First Name

Last Name

New Member *

Are you a new member?

Yes

Email *

What email address would you like us to use for communications?

Verify Email *

Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Phone *

What is your preferred phone number?

Twig Membership *

The Overlook Auxiliary Twigs were first formed in the 1940s and created a legacy of like-minded people giving back to Overlook Medical Center. Currently, the Auxiliary has active Twigs which bring innovative ideas for fundraising and service projects.

I currently belong to a Twig

I am interested in joining a Twig, please help me choose.

I am interested in joining the new NP Twig 11 MHA Twig

I am interested in starting a Twig , please send me information

No thanks, I'm not interested right now.

Which Twig(s) do you belong to? *

Check all that apply.

NP Twig 10

NP Twig 11 MHA

SH Twig 18

SH Twig 27

SU Twig 11

SU Twig 25

Photo Consent *

I give the Overlook Auxiliary and Atlantic Health System (AHS) my permission to use my photo/image and personally identifiable information to be published in print media, on the internet, and/or on social media, on TV, the Overlook Auxiliary website, the AHS website and any other publications of the Overlook Auxiliary and AHS.

YES

Dues

Adult Dues are $50 with two additional levels (Note: names of Patrons and Benefactors will be listed in our member newsletter, The Pulse).

Amount *

$250 - Benefactor

$100 - Patron

$50 - Adult Member

Donation Schedule

Add 3% to my total amount to help cover the payment processing fees