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ILA Membership Application (individual or federated members, or branches)
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Please choose the type of membership you apply for
Federated member (representative of a registered non-profit prolongevity organization)
Individual member (active longevity advocate, activist and/or scientist)
ILA Branch (representative of an emerging, not yet registered prolongevity organization/group)
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Your full name
Your answer
Your position in your organization
Your answer
Your organization name
Your answer
Your organization full address (including postal code)
Your answer
Your phone number
Your answer
Your email address
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Website and/or social media page
Your answer
Please briefly describe your and/or your organization's contribution to the longevity field, past, present and planned. Please add any relevant details about yourself and/or your organization.
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How do you envision your cooperation with and within the ILA for the advancement of the longevity field? What would be the goals and ways of cooperation?
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By sending this form I confirm that I have read the ILA manifesto, and I express my readiness to support the development of therapies and technologies for healthy longevity by means listed in the Manifesto.
Yes, I have read the Manifesto and I agree with it
No, I have not read the Manifesto
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