Print out and mail this form. Make checks/money orders payable to ADAC.
__ $50 Organization/Agency Membership
__ $10 Individual Membership
Name:
_______________________________________________________________
Organization/Agency:
_______________________________________________________________
Address:
_______________________________________________________________
City _____________________________ State______ Zip_________________
Phone ______________________________ Fax ________________________
Email __________________________________________________________
Return to:
Judy R. Roy
Alabama Disabilities Action Coalition
206 13th Street South
Birmingham, AL 35233-1317