866-425-3678 office@theial.com

IAL Club Application

Club Application

Application For Membership

The information you provide will reflect how your club is listed in the IAL Directory and who will receive IAL correspondence. Please complete fully and clearly and either type or print.

Club Name: _____________________________________________________________________

Club Location: City _______________________________________________________________
State _______________________ Country _________   Zip __________

Meeting Place: __________________________________________________________
Address ____________________________ City ______________________ State _____
Meeting Time: ______________ AM or PM
Day: Circle all that apply; 1st 2nd 3rd 4th every Mon Tues Wed Thur Fri Sat Sun
How Often: Weekly Monthly Bi-Monthly Other _____________ Except_________________


Contact Person to be listed in Directory Person to whom IAL mail should be sent
Name: Name:
Address: Address:
City: City:
State_______ ZIP____________ State_______ ZIP____________
Country: Country:
Phone: Phone:
Email: Email:
When Available:


Membership Dues

The number of voting delegates your club can have at a delegates meeting is based on membership:

Clubs with membership of 1-10 members…. $25 per year 1 Delegate
Clubs with membership of 11-20 members…. $45 per year 2 Delegates
Clubs with membership of 21-30 members…. $70 per year 3 Delegates
Clubs with membership of 31-40 members…. $90 per year 4 Delegates
Clubs with membership of 41-50 members…. $110 per year 5 Delegates
Clubs with membership of 51-60 members…. $130 per year 6 Delegates
Clubs with over 61 members…. $175 per year 8 Delegates
Regional Organizations…. $175 per year 8 Delegates


In addition to paying dues, each organization at the beginning of each year must acknowledge and accept in writing the Charter Standards.



Pursuant to Article IV, Section C of the Bylaws of the International Association of Laryngectomees, as adopted August 5, by the membership.

1. In every case the organization shall be known as “The [name of the organization] with the words “International Association of Laryngectomees” either preceding the name or following the name, with the phrase “Member of” (IAL). 2. Member organizations shall observe and comply with the provisions of the bylaws of the IAL and with such restrictions as may be made from time to time by the Association’s Board of Directors.
3. Each member organization shall have and operate under its own bylaws, in so far as they do not conflict with the Bylaws of the IAL. 4. Each Member organization shall strive to maintain an effective, active program.
5. Each member organization shall cooperate with the medical profession. 6. Each member organization shall cooperate with quasi-medical agencies and organizations, whether they be public, private or governmental, if they are able to assist in the total rehabilitation of laryngectomees.
7. Each member organization shall cooperate with recognized cancer fighting organizations such as the American Cancer Society, in the overall fight against cancer. 8. Each member organization, whenever possible, shall provide transportation for patients to training centers for the teaching of alaryngeal speech.
 9. Each member organization shall strive for the following committee structure:

A Professional Advisory Committee
A Patient Visiting Committee
A Public Information Committee
A Rehabilitation Committee


(Name of Club)

Acknowledges receipt of, and expresses its intent to carry out, the Charter Standards of the IAL in so far as possible.




Number of dues paying and/or participating club members:_____________Amount of Dues enclosed:_____________


Individual Membership Cards and Club Certificates will only be sent upon request from now on.  This is based on numerous Clubs’ reporting that they do not issue the cards and they have no place to display the certificate.  If you need them, we will be happy to provide them.  If you do not need them, you can help us save money by not requesting them.

Number of Membership Cards needed (Maximum is based upon dues paid): _____________
Please send us a Club Membership Certificate:   Yes ________  No ______

Please sign and mail with your dues check made out to the International Association of Laryngectomees (IAL) to:

International Assoication of Laryngectomees
925B Peachtree St NE, Suite 316
Atlanta, GA 30309

E-mail: ialed@theial.com This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Website: www.TheIAL.com