International Lutheran Deaf Association

ILDA Membership
Enrollment form

Please fill in the information needed, print this form to your printer, make check payable to ILDA Treasurer and mail form & payment to:

David G. Brown, ILDA Treasurer
Holy Cross Deaf Lutheran Church
360 Morse Rd
Columbus, OH 43214-1722

Your 2-year membership due $30.00
Type of Membership (please check one)
  Active Associate Supporting

$
Spouse membership due $30.00 (if applicable)
Type of Membership (please check one)
  Active Associate Supporting
$
Total $

 Full name & title     
 Spouse's full name
 Street address Apt #
 City State/Province
 Zip + four/Postal code Country
 Phone (tty or voice?)
 E-mail

Thank you for your support!