DIAL-CIL.org

 

Membership

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A Disability Services Organization


DIAL, Inc. Membership Application Form


I would like to be a member of DIAL and contribute to independent living for all people.


Name
Address
City
State
ZIP Code
Telephone Number
Membership
Options
New Renewing
(All memberships expire 12/31 of each year)





Send your membership check or money order to:

DIAL, Inc.
Center for Independent Living
2 Propect Village Plaza
Floor 1
Clifton, NJ 07013-1918

If you wish to download the membership application form, please visit the downloads page located on the menu bar for the DIAL, Inc website.





 
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