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Membership

LIFE Center for Independent Living is a membership organization. Membership is open to all individuals with disabilities and their families, and to persons and businesses who support our mission. Members help us to promote advocacy and increase community awareness of disability issues. As a member, you receive our newsletters and fliers and you are invited to all our events. You have a vote at our Annual Meeting and you may run for and/or vote for our Board of Directors.

For more information on Membership, please call contact .

Choose One:	New Membership Membership Renewal
Date:
Name:
Business: (if applicable)
Title:
Address:
City:
State:
Zip:
Home Phone:
Please Check One	Voice TTY FAX
Other Phone:
Please Check One	Voice TTY FAX
E-mail:
I/we endorse the mission of LIFE Center and want to become a member(s). (Choose one.)	Individual Membership (1 person) $10 Family (2 or more members of the same family) $25 Not for Profit Business/Agency $50 For Profit Business Membership $75 LIFEtime Membership $200
How did you hear about LIFEcenter? (Choose one.)	Consumer Brochure Phone Book Equipment Loan Poster Radio Agency Referral Newspaper TV Firend/Family Website Other
Check ALL the services your are interested in and would like more information:	Individual Services Workshops Board/Committee Services Disability Services Advocacy Peer Mentoring Volunteer Opportunities Special Events Community Services Support Groups Donation Opportunities Other
Wou can pay online at the following link:	Make checks payable to: LIFE Center for Independent Living. LIFE Center for Independent Living is a charitable, non-profit 501(C)(3) organization and your membership fee is tax deductible as allowed by law. Return your form and payment to LIFE Center for Independent Living's Bloomington Office at the address given above.

center activities | contact us | advocacy hot topics | contact your legislators |
community services | individual and group services | what is independent living? |
Life-Lines Newsletter | membership | mailing list | make a donation | volunteer|
board nomination | employment | map | links | large print version | home |