ADA member number: ____________.
You must be a member of the American Dietetic Association to join TDA as validated by your ADA membership number. For information on ADA membership, visit www.eatright.org and click on the Join ADA tab.
INSTRUCTIONS:
- Complete the personal information exactly as you want the information printed for the directory.
- Check your desired membership category:
Regular member = $30.00
Retired RD = $10.00
Student = $10.00
- Each year we like to recognize and support our outstanding dietetic students by awarding a financial scholarship. If you would like to make a tax-deductible contribution, please indicate the additional amount and include it with your membership dues check.
I would like to contribute $_____ amount to the scholarship fund.
Membership dues:
Optional contribution:
Total Payment:
Send the completed membership form and your check (made payable to the TDA) to our TDA Membership chair by mail or email:
Heather Fisher
6600 War Admiral Trail
Tallahassee, FL 32309
hfisher@admin.fsu.edu
You may pay your dues at the first TDA meeting if your form is sent electronically or mail the check.
Please use your cancelled check as your receipt.
Please submit membership dues on or before - November 1, 2008.
Please provide us with your contact information:
Name___________________________________________Credentials________________
Title/Place of Employment____________________________________________________
Mailing Address____________________________________________________________
City _________________________________________________Zip Code_____________
Business Phone (850) _____________________Home Phone (850) _________________
Email Address_____________________________________________________________
Fax Number (850) __________________________________________________________
TDA corresponds with members via email communication and postings on our website. Please check our website regularly for updates: http://www.eatrighttallahassee.org/
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