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ADL ALUMNI ASSOCIATION ON-LINE MEMBERSHIP APPLICATION
For All New England Based Alumni and Available to All Other Alumni
Note: This form should only be completed if you intend to pay your US$40 membership fee on-line using PayPal. If you plan to mail a check for membership, please retrieve the print version of the membership form.
You have selected the following membership type:

$40 Full Membership (Available to all Members, Required for New England Based Alumni)
Includes: Free Annual Reunion and reduced fee at Speaker Meetings.
If you are a non-New England based alumnus and desire a limited membership,
please return to the select membership type page.

Step 2: Complete the Information Requested Below:

Fields with (*) are required.

*This is a (pick one): Renewal New Membership
*Years at ADL: From to 25-Year Club? (Y/N) Yes No
*Your Name:

*Home Address:
* Phone Number:
   Fax Number:
   E-mail Address:
   Please provide if available (required for receiving event announcements via email).

*Send me event announcements by: Email Postal Mail
  Secondary Address:
    Business
    Second home
If your secondary address is a seasonal residence, please give the applicable dates:
Start Date: End Date:
Secondary Phone Number:
Secondary E-mail Address:
Permission to Use Your Information

When we update the Alumni Directory Book, the home address, phone, and email will be included unless you you uncheck the box below.
ADLAA may print my home address, phone, and email information in the print directory. (clear box if you do not want us to distribute any of this data to other members). If you want us to exclude specific info from the print directory or include a date-specific alternative address, please explain below:
      

We are planning to create a password-protected on-line directory in the future. In addition to home information, we plan to include the secondary address, phone, and email provided unless you uncheck the box below.
ADLAA may include my home information and business/secondary address information in the web directory. (clear box if you do not want us to distribute any of this data to other members on-line). If you want us to exclude specific info from the web directory, please explain below:
      


We'd Like Your Input

Please give us your suggestions for program events, activities, and/or locations.
      

Do you know someone who might be a speaker for an ADLAA meeting?
(Please provide speaker's name and/or topic.)
      

       Would you be willing to follow-up with him/her in this regard? (Yes/No)
       Yes No

Do you know other ADL Alumni who might be interested in joining the ADLAA?
Please give us their name and postal address so we can send them an invitation to join.
      

Report your news in our newsletter (trips, family news, professional news, pro bono work, etc.)
      

After clicking the Submit Data button below, you will be directed to a payment selection page. On-line payments can only be made through PayPal. If you do not currently have an account with PayPal, you will be given an opportunity to open one. You will also be able to complete your transaction using a credit card, without opening an account. If you do not want to continue processing your membershp payment on-line, you may clear the form by using the Reset button.



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The ADL Alumni Association
P.O. Box 222
Arlington, MA 02476
© Copyright 2008 The ADL Alumni Association. All Rights Reserved.
The ADL Alumni Association is a not-for-profit organization comprised of the
former employees of Arthur D. Little and its subsidiaries prior to the sale of the company in 2002.