Membership-Form

I am a *

renewing member
new member

Name *

First

Last

Title/Position *

Firm/Organization *

Email *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Please consider volunteering for an ABLL Committee. You may select more than one.

Annual Holiday Charity Drive
Brown Bag Luncheons
Education
Membership
Newsletter
Nominating
Public Relations
Technology

To add/renew additional members from your organization, please enter their full name, title, and email below.

If paying for multiple members via PayPal, please edit the quantity of memberships on the PayPal checkout page.

Payment

Membership Type *

Individual ($110)
Vendor ($110)
Shared Individual ($110)
Shared Vendor ($110)
Retired ($40)
Unemployed ($40)
Student (40)
Pro-rated ($55, available to new members between January and May)

Membership dues include all fees to attend educational programs and other events, i.e. registration, food, beverages.

Payment method *

I will pay via PayPal (PayPal link will appear on confirmation page, after clicking Submit)
Please invoice my firm via PayPal
I will send a check via mail

Please send checks to Meagan Stefanow, Insurance Library Association of Boston, 156 State St. #2, Boston MA 02109

Please enter details on how to invoice your firm. Include name, e-mail address, and any additional billing information necessary (i.e. a PO number or billing account number).

Please enter a check number

If you would like a copy of this form, please print this page before clicking Submit.

You will receive a confirmation message on the next screen.

Email *

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