May Spirit guide us . . .

“Thanks to Manifest I have a home, a place to practice & teach yoga, and a place to dance. I appreciate being part of a community where we respect one another’s space and nurture one another to grow.”
— Levi Banner, 26, break dancer, yoga teacher, & green energy advocate

Health Provider

Become a Health Provider Member TODAY!

Wellness Professionals (doctors, acupuncturists, naturopaths, psychotherapists, massage therapists, personal trainers, life coaches, etc) are invited to join Manifest, a non-profit men’s wellness community to receive the following professional benefits (see specific benefits for each level of membership below):

* ONLINE REFERRALS of potential clients to your business from your free listing on the Manifest website, which receives thousands of visitors monthly
* Ability to make DIRECT CONTACT with POTENTIAL CLIENTS by making announcements at any of more than 30 Manifest events monthly, and by presenting a 1/2 hour talk at one of our monthly open houses
* 10% DISCOUNT on wellness services from other wellness professional members
* FREE MANIFEST EVENTS:  choose from more than 30 events monthly (the number of events you may attend for free depends on which membership level you choose)
* 50% of your dues are TAX DEDUCTIBLE as a charitable contribution and the other 50% will likely be tax deductible as a legitimate business expense (for marketing &/or training)
* FREE HEALTH CLUB MEMBERSHIP at West Coast Health & Fitness
* FREE wellness professional MARKETING & BRANDING SEMINAR
* FREE PROFESSIONAL MASSAGE (for members at Sponsor level & above)

Please review the specific benefits for each level of membership below and either join online or print out the application below and mail it to us.  Call Bart at 503-223-8822 x1 if you have questions about professional membership.

Become a Health Provider Member TODAY!

MANIFEST PROFESSIONAL MEMBERSHIP
BENEFITS & APPLICATION

Please fill out this application and mail it to:

Manifest
4906 NE 22nd Ave.
Portland, OR 97211

MEMBERSHIP LEVELS & BENEFITS (please check one)

__ PARTNER $200/month

* UNLIMITED FREE EVENTS:  you & a friend or partner receive unlimited free manifest events & programs (more than 30 events/month which cost an average of $15/event)
* FREE FITNESS CLUB MEMBERSHIPS:  2 one-month FREE memberships to West Coast Health & Fitness
* 2 FREE MASSAGES:  2 Complimentary Coupons for 1-hour Massages by a Licensed Massage Therapist
*  TAX DEDUCTION:  Receipt for $100/month tax deductible donation ($1200/year)
* ONLINE DIRECTORY LISTING:  Full Page Listing (with photo) in the Manifest website’s men’s wellness resource directory; plus a 2ndfull page listing in our online list of sponsors
* IN-PERSON PRESENTATION TO POTENTIAL CLIENTS:  Opportunity to talk directly to potential clients in at least one Manifest Open House per year (1/2 hour presentation w/ Q&A)
* FREE MARKETING SEMINAR:  Free attendance at a Web Development & Online Marketing Workshop specifically for health providers offered by two consultants who specialize in health provider marketing & web development
* DISCOUNT ON WELLNESS SERVICES:  10% Discount on Manifest Health Provider Member services

__ BENEFACTOR $100/month

* UNLIMITED FREE EVENTS:  unlimited free manifest events & programs (more than 30 events/month which cost an average of $15/event)
* FREE FITNESS CLUB MEMBERSHIP:  A One-Month FREE memberships to West Coast Health & Fitness
* FREE MASSAGE:  A Complimentary Coupon for a 1-hour Massage by a Licensed Massage Therapist
*  TAX DEDUCTION:  Receipt for $50/month tax deductible donation ($600/year)
* ONLINE DIRECTORY LISTING:  Half Page Listing (with photo) in the Manifest website’s men’s wellness resource directory; plus a 2nd 1/2 page listing in our online list of sponsors
* IN-PERSON PRESENTATION TO POTENTIAL CLIENTS:  Opportunity to talk directly to potential clients in at least one Manifest Open House per year (1/2 hour presentation w/ Q&A)
* FREE MARKETING SEMINAR:  Free attendance at a Web Development & Online Marketing Workshop specifically for health providers offered by two consultants who specialize in health provider marketing & web development
* DISCOUNT ON WELLNESS SERVICES:  10% Discount on Manifest Wellness Provider Member services

__ SPONSOR $50/month

* 5 FREE EVENTS/MONTH:  attend five free manifest events or programs per month (choose from more than 30 events/month which cost an average of $15/event)
* FREE FITNESS CLUB MEMBERSHIP:  A 2-week FREE memberships to West Coast Health & Fitness
* FREE MASSAGE:  A Complimentary Coupon for a 1-hour Massage by a Licensed Massage Therapist
*  TAX DEDUCTION:  Receipt for $25/month tax deductible donation ($300/year)
* ONLINE DIRECTORY LISTING:  1/4 Page Listing (with photo) in the Manifest website’s men’s wellness resource directory; plus a 2nd 1/4 page listing in our online list of sponsors
* FREE MARKETING SEMINAR:  Free attendance at a Web Development & Online Marketing Workshop specifically for health providers offered by two consultants who specialize in health provider marketing & web development
* DISCOUNT ON WELLNESS SERVICES:  10% Discount on Manifest Wellness Provider Member services

__ REGULAR ($10/month)

* ONE FREE EVENT/MONTH:  attend five free manifest events or programs per month (choose from more than 30 events/month which cost an average of $15/event)
* FREE FITNESS CLUB MEMBERSHIP:  A 1-week FREE membership to West Coast Health & Fitness
* TAX DEDUCTION:  Receipt for $5/month tax deductible donation ($60/year)
* ONLINE DIRECTORY LISTING:  Short Listing in Manifest’s Online Men’s Wellness Resource Directory; you can list your contact information plus a 1-line (75 word) description of your services
* FREE MARKETING SEMINAR:  Free attendance at a Web Development & Online Marketing Workshop specifically for health providers offered by two consultants who specialize in health provider marketing & web development
* DISCOUNT ON WELLNESS SERVICES:  10% Discount on Manifest Wellness Provider Member services

Name_______________________________________________________________

Business Name__________________________________________________________

Street Address__________________________________________________________

City/State_______________________________________Zip____________________

Email_________________________________________________________________

Eve Phone_____________________________________________________________

Day Phone____________________________________________________________

Email________________________________________________________________

Credit Card #__________________________________________________________

Security Code (on back of card)___________________________________________

Expiration Date________________________________________________________

Program/Referred By___________________________________________________

__I authorize Manifest to charge the debit or credit card listed above the amount indicated above each month; OR
__I enclose my first monthly dues check (payable to “Manifest”), and request Manifest invoice me each month via email (and I’ll send a check via mail or electronically).

___________________________________ _________________
Signature           Date