Print out registration form, complete and mail with payment to:

Arizona Association for Lifelong Learning
PO Box 16021
Phoenix, AZ 85011-6021

Name:

Mailing Address:

City

State

Zip

Agency Affiliation

Home Phone:

() -

Work Phone:

() - ext.

Fax:

() -

email:

would you like to join the AALLTALK listserve? (circle)  yes--no

Other Address: (optional)

Please indicate the areas in which you have interest or expertise or would like to be involved with AALL: (check all that apply)

Adult Basic Education/ Literacy
Community Education
Continuing Education
Correctional Programs
Citizenship
Developmental Disabilities
Elder Issues
English for Speakers of Other Languages (ESOL)
Family Literacy

GED
Grant Writing
Higher Ed. (Community College, University, Voc/Tech)
K-12 (Grade/Subject)
Homeless Education
Legislation
Library
Life Skills
Native American Education

Program Development
Publicity/Public Relations
Technology
Workplace/Workforce Education
Other (Specify)
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Membership Fee:

1 Year Individual $30 ____
1 Year Student $10 ____ (Please include name of instructor & institution/program)
1 Year Dual AALL & *MPAEA $60 ____ / Student $40 ____
2 Year Individual AALL $50 ____
2 Year AALL/1 Year MPAEA $80 ____
1 year Institutional $40__ 
 2 year Institutional $75___

*Mountain Plains Adult Education Association