NLDline

Join the Membership!

 

  NONVERBAL LEARNING DISORDERS ASSOCIATION  

2446 Albany Avenue

West Hartford, Connecticut 06117

(860) 570 0218

email: NLDAorg@aol.com

YES! I would like to become a member of the NLDA

Category:                   _____ Individual:          $50

                                    _____ Family:                $75

                                    _____ Professional:      $75

Please make checks payable to NLDA - A non-profit, tax-deductible organization

 

Name:                                                                                                                         

Address:                                                                                                                                  

                                                                                                                                               

Phone Number:                                                                                                                       

E-Mail Address:                                                                                                                      

What is your relationship to NLD? Check all that are relevant.

____Parent of a child with NLD                                   ____Relative of a child with NLD

Age of child      ____               Gender____                 Grade____     Age at Diagnosis____

____Adult with NLD

____Professional provider of services to a person with NLD

(Please describe)                                                                                             

                                                                                                                                               

____Special education professional

____Other (Please describe) ____________________________________________________                                                                                                                                                                                                                                      

What experience or expertise can you bring to NLDA?_______________________________                                                                                                                                                                 

Please use the back of this sheet for other relevant information.