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

You can join the Albuquerque chapter or pay dues (1) printing this page and filling out the Membership Application / Dues form below OR (2) open the Membership Application / Dues document below  (it is in a pdf format), print it out, and fill out the form OR (3) Click on the link below to pay with a credit Card.  
If you do (1) or (2), mail your application to the address shown on the application, along with your check or money order to cover the annual chapter dues. 
 
If you do (3), your application and payment are electronically submitted. 

The annual chapter dues also includes your subscription to the chapter's newsletter - Wired for Sound.
Option (3) Membership Application / Dues Form (Print this Page)

Name ________________________________________________________________________


Address  __________________________________________________Apt. Number _________


City  ___________________________________________  State_______Zip _______________


Phone _______________________________________________________________ 


email ________________________________________________________________


                                                              New / Renewal 

PLEASE CHECK APPROPRIATE LINE  

                                  ____    Annual Dues: $15.00 

                                  ____    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.

Email: [email protected]
Phone: (505) 219 1962

Option (1).
 Albuquerque Chapter