Membership Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Membership Form

DYSLEXIA ASSOCIATION OF TRINIDAD & TOBAGO

Membership is open to anyone who is interested in helping our cause. Members receive notices of events and only members can borrow resources from the Association’s Library. If you wish to become a member of the Dyslexia Association, please complete and submit this form.

Type of membership *

Annual membership fees are quoted in Trinidad & Tobago dollars below. Contact us at (868) 625-5869 for other payments options * Cheques are payable to: Dyslexia Association * Mailing address: 31 Alberto Street, Woodbrook, Trinidad & Tobago, W.I.

Full-time Student: $15

Basic Membership: $30

Supporting member: $100 (a slightly higher fee that contributes to operational costs)

Lifetime member: $500 (a one-time payment)

Name:l *

Address:

Email address:

Phone number: *

Special interests:

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms