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National Council
on Independent Living
 
 
Not Just Responding To
Change, But Leading It!
 

Centers for Independent Living and Statewide Independent Living Councils Membership Application

Memberships are renewable annually and payment is due by January 31. Dues must be paid in full by June 9, 2006, thirty business days prior to the commencement of NCIL’s annual conference to insure voting privileges at the Annual Council Meeting. Dues are based on each CIL/SILC or organization's budget (not including
pass-through funds.)

Upon payment of appropriate dues, it shall be assumed that a member automatically supports NCIL’s mission, goals, advocacy priorities, and the IL philosophy; copies of which shall be forwarded to all members annually by the NCIL office with a notation that they are what the dues and membership support.

Required Information is noted with an asterisk (*).


Membership Year: January 1 - December 31, 2008

  

Membership

Membership Applications

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*Membership:

Center for Independent Living
SILC Membership

Are you a New or Renewing Member? Please select one:

New Member

              Region (if known):               

              *Executive Director's Name:

              *Organization Name:           
                                                           (please spell out, without acronyms)

              *Mailing Address Line 1:      

              Mailing Address Line 2:        

              *City:                                   

              *State/Territory:               

              *Zip Code:     

              *Fax:              

              *E-mail Address:                 

              Web Site (if applicable):      

              *Operating Budget:            

 View Membership Dues Chart for CILs and SILCs

Note: New members may reduce your dues by 25%! See Dues Chart for more information.

Do you want to ensure that there is a consumer control voice advocating in Washington by supporting NCIL with an additional contribution? You will be asked to repeat this selection in the online store (page 2!).

Amount of Additional Donation:

                                                               

                   

              *Total amount of payment $

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*MATERIALS: All NCIL publications are mailed standard print and/or emailed in text format.  Please indicate whether you would like to receive publications in the following formats:

Braille                CD (Text format)                Large Print                Tape

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In order to be considered for CIL/SILC membership, CILs/SILCs shall submit a copy of the CIL or SILC grant award notification from the U.S. Department of Education or a letter from your state funding agency saying that you receive funding as a CIL or SILC with its application and dues.

Check here if you DO NOT receive or wish to submit a grant award notification letter from the U.S. Department of Education or a letter from a state agency showing you are funded as a CIL or SILC, and would like to petition the NCIL membership committee to review additional documents as proof that your application meets NCIL’s criteria as a CIL/ SILC member.

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