LIRID Membership Form 2023-2024

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Welcome! Please fill out the following form entirely to become a member of LIRID. Once submitted, you will be directed to complete Dues payment via PayPal. You must submit both the form and payment to be considered a member in good standing of LIRID.

You will receive an email copy of your form response and a receipt from PayPal. Thank you for joining LIRID!

Please contact Alyssa, membership@lirid.org with any questions or concerns.

Email *

Name *

Street Address *

Town, State, Zip *

Mobile Phone

Work Phone

Home Phone

Certifications *

Please Select all that apply

NIC (includes Advanced, Master)

CDI

BEI (includes Basic, Advanced, Master)

None

Other:

Required

Additional interpreting credentials

(ex: SC:L, Trilingual, EIPA [include score], Etc.)

RID Member Number *

If applying as a supporting or organizational member, please type 000

Please Select Any Information You Wish to be Included on the LIRID Website Registry *

Any information you do not select will remain confidential

Name

Street Address

Town, State, Zip

Mobile Phone

Work Phone

Home Phone

Certifications

Membership Level

Additional Interpreting Credentials

Required

Membership Categories *

Certified, Voting, $30 *RID Membership Required*

Associate, Voting, $25 *RID Membership Required*

Student, Non-Voting, $25 *RID Membership Required*

Supporting, Non-Voting, $25

Organizational, Non-Voting, $35

Volunteers Needed! Please check any area you feel you could help. A committee member will contact you:

Professional Development

Mentorship

Fundraising

Membership

Communications (Social Media, Newsletter, Webmaster)

Bylaws

Other:

A copy of your responses will be emailed to the address you provided.

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