We invite you to join the Hearing Loss Association of America -
Albuquerque Chapter

You can join the Albuquerque chapter by (1) printing this page and filling out the application form below OR (2) open the Membership Application document above (it is in a pdf format), print it out, and fill out the application form.  Then mail your application to the address shown on the application, along with your check or money order to cover the annual chapter fee.  The annual chapter fee also includes your subscription to the chapter's newsletter - Wired for Sound.
Application Form

Name ________________________________________________________________________

Address  __________________________________________________Apt. Number _________

City  ___________________________________________  State_______Zip _______________

Phone _______________________________________________________________ 

email ________________________________________________________________

                                                              New  Renewal 

PLEASE CHECK APPROPRIATE LINE     ____    ____    Individual Annual Dues: $15.00 

                                 ____    ____    Family Annual Dues: $20.00

                                 ____    ____    Newsletter Subscription Only:  $7.50 

                                                      Donation:  $ ________________

If you want your donation to be anonymous, check here________

                                                    Total  __________

Please make check payable to HLAABQ 
Please mail to: HLAAbq  l  P.O. Box 36792 l Albuquerque, NM 87176 or Bring to a Chapter Meeting.

 Albuquerque Chapter
Email: hlaabq@gmail.com
Phone: (505) 219 1962