Institutional Membership Application
INSTITUTIONAL DUES STRUCTURE

These contributions will be placed in the IALS Endowment Fund from which only the interest and a small amount
of the capital is drawn to support research grants and special projects.

Institutional or individual members who give an additional contribution of at least $100 above their annual membership
fees will be recognized as benefactors and will be listed on the IALS website and on the annual conference program.

Fees can be paid by PayPal on the IALS Membership page or pay by check:

Make checks payable to: IALS & MAIL TO: Patricia E. Diebold
Executive Director
International Association of Laboratory Schools
Office: P.O. Box 510486
Key Colony Beach
Florida 33051
Questions may be sent to: IALS.EXEC.DIRECTOR@GMAIL.COM or phone: 814-881-7051
Renewed Institutional Membership Based on Actual Student Enrollment
First Year Institutional Membership
International Membership
In addition to the Institutional Membership Dues, our school would like to contribute to the IALS endowment fund in the amount of:
Laboratory or University Affiliated School Name: *
Your answer
College or University: *
Your answer
Address: *
Your answer
City, State, Zip: *
Your answer
Director or Principal: *
Your answer
Phone number: *
Your answer
Fax number: *
Your answer
E-Mail Address: *
Your answer
Web Site – URL *
Your answer
Other Principles and Titles:
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Name of the Dean of Education: *
Your answer
Address: *
Your answer
Private or Public: *
Source of Population: *
Your answer
Tuition: *
Your answer
Please submit a list of your faculty and staff with their emails so they may be included as IALS members and receive the latest news and information from the Association *
Your answer
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