National Coalition of Auditory Processing Disorders

To become a member of the NCAPD, please mail your completed membership form and check or money order made payable the NCAPD to:  

NCAPD
Attn: Membership
P.O. Box 494

Rockville Centre , NY 11571-0494

Membership Categories:

• _____ Individual/Family Membership: $25
• _____ Professional Membership: $25
• _____ Professional Directory Listing: $25 to be added to Professional Membership Fee

Please complete the following information:

Name: _______________________________________________________________________

Organization/Business Name:   ___________________________________________________

Address:   ____________________________________________________________________

City:   ___________________________ State: ______________ Zip Code :_______________

Country (if other than U.S. ) :__________________ Phone:   ___________________________

e-mail:   _____________________________________________________________________

Professional listing :

Name you want listed: _________________________________________________________

Business Name _______________________________________________________________

Address: _____________________________________________________________________

City:   ___________________________ State: _____________ Zip Code :________________

Phone: _________________________Email: ________________________________________

Website: ________________________________________________________________