International
Association of
Laryngectomees |
|
Application For Membership
The information you provide will reflect how your club is listed in the IAL Directory
and who will receive IAL correspondence. Please complete fully and clearly and either type or print.
Club Name:_____________________________________________________________________
Club Location: City_______________________________________________________________
State_______________________ Country_________ Zip__________
Meeting Place:__________________________________________________________
Address____________________________ City______________________ State_____
Meeting Time:______________ AM or PM
Day: Circle all that apply; 1st 2nd 3rd 4th every Mon Tues
Wed Thur Fri Sat Sun
How Often: Weekly Monthly Bi-Monthly Other_______________________________
| Contact Person to be listed in Directory |
Person to whom IAL mail should be sent |
| Name: |
Name: |
| Address: |
Address: |
| City: |
City: |
| State_______ ZIP____________ |
State_______ ZIP____________ |
| Country: |
Country: |
| Phone: |
Phone: |
| Email: |
Email: |
| When Available: |
|
Membership Dues: The number of voting delegates your
club can have at a delegates meeting is based on membership:
| Clubs with membership of 1-10 members…. |
$20 per year |
1 Delegate |
| Clubs with membership of 11-20 members…. |
$38 per year |
2 Delegates |
| Clubs with membership of 21-30 members…. |
$57 per year |
3 Delegates |
| Clubs with membership of 31-40 members…. |
$75 per year |
4 Delegates |
| Clubs with membership of 41-50 members…. |
$95 per year |
5 Delegates |
| Clubs with membership of 51-60 members…. |
$115 per year |
6 Delegates |
| Clubs with over 61 members…. |
$150 per year |
8 Delegates |
| Regional Organizations…. |
$150 per year |
8 Delegates |
In addition to paying dues, each organization at the beginning of each year must
acknowledge
and accept in writing the Charter Standards.
CHARTER STANDARDS
FOR IAL MEMBER ORGANIZATIONS
Pursuant to Article IV, Section C of the Bylaws of the International
Association of Laryngectomees, as adopted August 5, by the membership.
| 1. In every case the organization shall be known as "The [name of
the organization] with the words "International Association of Laryngectomees" either preceding the name or
following the name, with the phrase "Member of" (IAL). |
2. Member organizations shall observe and comply with the
provisions of the bylaws of the IAL and with such restrictions as may be made from time to time by the
Association’s Board of Directors. |
| 3. Each member organization shall have and operate under its own
bylaws, in so far as they do not conflict with the Bylaws of the IAL. |
4. Each Member organization shall strive to maintain an effective,
active program. |
| 5. Each member organization shall cooperate with the medical
profession. |
6. Each member organization shall cooperate with quasi-medical
agencies and organizations, whether they be public, private or governmental, if they are able to assist in the
total rehabilitation of laryngectomees. |
| 7. Each member organization shall cooperate with recognized cancer
fighting organizations such as the American Cancer Society, in the overall fight against cancer. |
8. Each member organization, whenever possible, shall provide
transportation for patients to training centers for the teaching of alaryngeal speech. |
9. Each member organization shall strive for the following committee structure:
A Professional Advisory Committee
A Patient Visiting Committee
A Public Information Committee
A Rehabilitation Committee
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The____________________________________
(Name of Club)
Acknowledges receipt of, and expresses its intent to carry out, the Charter Standards
of the IAL in so far as possible.
Signature__________________________________
Title______________________________________
Date______________________________________ |
Number of dues paying and/or participating club members:_____________ Amount of
Dues enclosed:_____________ |
Individual Membership Cards and Club Certificates will only be sent upon request
from now on. This is based on numerous Clubs' reporting that they do not issue the cards and they have
no place to display the certificate. If you need them, we will be happy to provide them. If you do
not need them, you can help us save money by not requesting them.
Number of Membership Cards needed (Maximum is based upon dues paid): _____________
Please send us a Club Membership Certificate: Yes ________ No ______
Please sign and mail with your dues check
made out to the International Association of Laryngectomees (IAL) to:
IAL
925B Peachtree Street NE, Suite 316
Atlanta, Georgia 30309
E-mail: ialhq@larynxlink.com
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