Membership is open to anyone interested in Late Deafened Issues. Members are eligible to vote, receive newsletters, and can get Chapter announcements e-mailed to them and/or join our e-mail support group online http://health.groups.yahoo.com/group/ALDA-Suncoast/

Your membership will be with the Suncoast Chapter of ALDA only, it does not include National ALDA Membership. There are additional benefits when you join the National Organization but it is not required for Chapter membership.

To Join ALDA Suncoast, mail your name, full address, phone number and e-mail address (or print and fill out the form below) and a check for your Annual Dues as shown below to:

ALDA-Suncoast of Florida
P. O. Box 4118
Clearwater, FL 33758

Annual Dues (from January 1 to December 31)

Individual Membership (One Person and Spouse/Domestic Partner) $15.00

Professional Membership (Family or Business) $35.00

All dues are owed in January.  Use the following table to determine your individual membership dues if joining in any month other than January:

Jan Feb March April May June July Aug Sept Oct Nov Dec
$15.00 $13.75 $12.50 $11.25 $10.00 $8.75 $7.50 $6.25 $5.00 $3.75 $2.50 $1.25

Please make checks payable to: ALDA-SUNCOAST OF FLORIDA

Donations Always Accepted.

 

(Only print page 2 for form.)

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I would like to become a member of ALDA-Suncoast.

I have enclosed my check for $_________ made out to

ALDA-Suncoast of Florida. Please send my newsletter to:

Name: _______________________________________

Address: _____________________ City_____________

State _______ Zip code: _______________

Telephone: ______________ (____TTY, ____Voice)

E-mail address: ___________________________________

(___Announcements, ___Support Group, ____E-newsletter)

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