NLDline
Join the Membership!
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?_______________________________