Join ALDA Suncoast

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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 Membership
c/o Deaf & Hearing Connection for Tampa Bay
7821 Seminole Blvd.
Seminole, FL 33772

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:
January $15.00     May $10.00   September $5.00
February $13.75    June $8.75    October $3.75
March $12.50        July $7.50       November $2.50
April $11.25        August $6.25     December $1.25

Please make checks payable to: ALDA-SUNCOAST OF FLORIDA

Donations Always Accepted.

Only print page two for form.

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To:  ALDA-Suncoast of Florida Membership
c/o Deaf & Hearing Connection for Tampa Bay
7821 Seminole Blvd.
Seminole, FL 33772
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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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