NLA - Interational
Individual Membership Application
Membership Year July 1 - June 30

For a copy of the individual membership brochure, click

To pay by check or to register more than one person, please feel free to download and mail in the form



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Chapter Information
NLA-I has chapters in the following locations. If you wish to be contacted by a chapter, check the appropriate chapter. If there is not a chapter near you OR you wish to join as in Independent member, check Independent.

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Dues Schedule

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Please make a selectio International: Rates equivalent to above rates on current Exchange Rates ... prorated as indicated above

NOTE: If you would like to add an amount for one of our projects please fill that information in below and add the money to your chosen method of payment or choose the donation button on the payment page.

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I have read the NLA-I Statement of Purpose. I agree with the goals of NLA-I and wish to support its efforts of activism, concern, education, and public service. I understand that information on this form will be handled according to the confidentiality rules set forth in the Bylaws.

I attest by my typed signature that I am at least 18 years of age and/legal age in my state of residence.

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