Membership Application 

 

There are two categories of memberships – Individual and Organizational.  All memberships are based for the calendar year – January to December.

Individual Membership Dues $10 – individual membership is open to any person who chooses to be a member of the organization.  It may be an individual with a disability, a self-advocate, a family member, friend, professional, or community supporter.  However, the Voting Advocate Members is anyone who identifies with having a disability, who is16 years of age or older, and a citizen of Alabama.

Organizational Membership Dues $50.  Please contact the AL DAN office to learn more about organization al memberships.  Or we can create a separate application for organizational memberships.

 

Individuals may join online by completing the form below and use PayPal to pay dues by PayPal or Credit Card:

First Name:
Last Name:
Address:
City:
State:
Zip Code:
Phone Number
Email Address:
Comments:
I would be interested in learning more about Committee Involvement:
Advocacy Committees
Transportation/Housing
Education
Healthcare
Organizational Committees
Membership/Communication
Fundraising
Category
Individual with a Disability
Self-Advocate
Family Member
Friend
Professional
Community Member
Do not enter anything in this field:

Click the "Buy Now" button below to pay membership dues by PayPal or Credit Card
Membership Dues
 If you would like to mail payment, please click the link below, print the application, and make check payable to AL DAN and send to 206 13th Street South, Birmingham, AL 35233 ATTN Beth Blalock

Membership Application
Advocating For Positive Change

Beth Blalock

AL DAN
206 13th St South
Birmingham, AL 35233
Phone: 205-251-2223, ext. 113 

Email: beth.aldan@bellsouth.net

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("This project is developed under a grant from the Alabama Council for Developmental Disabilities (ACDD).  However, these contents do not necessariliy represent the views or policies of the Council")



 

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