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Membership runs from April - March,
annually. Please Note: Memberships
are no longer pro-rated. MEMBER REGISTRATION FORM (Please
Print Clearly) Name:
________________________________________________________________________ Title: ________________________________________________________________________ Organization: _________________________________________________________________ Address:
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________ Phone: Home / Cell / Work ______________________________________________________
Email: Home
/ Work _________________________________________________________ ____ YES, it is okay to include my name and contact information in a NECLP
Directory. ____ NO, I prefer for my information to not be included in the NECLP Directory. Membership dues: _____ $25 annually for professionals _____ $20 annually for students (with proof) Please make checks payable to: New England Child
Life Professionals, Inc.
Please mail to: New England Child Life Professionals, Inc. c/o Kelly Duda 53 Murdock Street Somerville, MA 02145 |
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