Print Membership Form
Arizona Association of the Deaf, Inc
Lifetime Membership Form
Fill in boxes by typing then print the form and mail.
New Renewal Change of Address
Full Name:
Address:
Apt/Unit/Site:
City/State/Zip:
TTY Voice Both:
 VP:
 Fax:
E-mail:
Your Signature:

    		Date:
ASDB Alumni? Yes  PDSD Alumni? Yes
Check the box and fill out the amount below:
 Lifetime Membership Due: $
Contribution (The AzAD is a 501(c)(3) organization; allcontributions are tax-deductible to the extent allowed by the law.) $
Thank you for supporting AzAD!     Total Amount: $
Please pay above total amount to authorized person or mail check or money order payable to:
Arizona Association of the Deaf, Inc
5025 N. Central Ave.  PMB #277
Phoenix, Arizona 85012
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