Celiac Sprue Association (CSA), San Diego Chapter #57
About CSA Chapter #57: Our support group meetings are held every other month, and involve sharing information about Celiac Disease (CD) and Dermatitis Herpetiformis (DH), guest speakers, potlucks, and more. We also have a dining-out group and provide a bi-monthly newsletter. Further information about our group is on the website at www.glutenfreeinsd.com under “Support Groups”.
To join: Please fill out this membership form and include $15.00 per family for annual dues (January to December). Please make checks payable to: CSA
San Diego Chapter #57. Any additional contributions in support of the work our chapter is doing will be greatly appreciated.
If mailing, please send to: CSA Chapter #57, c/o April Hammarsten, 10345 Bart Way, Santee, CA 92071.
New ______ Renewal _______ Date ___________________________
Address ________________________________________________ City
Zip ___________ Phone ______________________ Email Address* _________________________
*Your email will only be used for our email and to make occasional announcements concerning our group.
Occupation (optional) _______________________________
Number of immediate family members with CD or DH in each age category:
1-10_____ 21-40______ 41-60______ 61+_____
Was the Celiac Disease medically diagnosed? _______ If so, in what year(s)? _______________
Do you or a family member have DH? ________
If you would prefer to receive your newsletter by mail rather than e-mail, initial here ____________
Please check the area(s) in which you would be willing to help the support group:
Refreshments _____ Computer _____ Phone Contacts _______
Committee member _____ Other _____ (please write on back of this sheet.)
To receive Lifeline, a very informative quarterly newsletter, join our national organization – CSA/USA (www.csaceliacs.org, 877-272-4272). Send $33 (new member), or $25 (annual renewal) to:
Celiac Sprue AssociationP.O. Box 317,
Omaha, NE 68131-0700