Member Organization Application Form - Aaalac

Application to become anAAALAC InternationalMember OrganizationPlease provide the following information forconsideration with your application formembership and certify that all materials havebeen submitted by signing belowCompleted Membership ApplicationMission statement or statement of purposeMembership prerequisitesCurrent BylawsAnnual report, including annual budgetand tax statusPosition statement and/or policy affirmingthe importance of appropriate animalcare and useInstructions to authors or grantees as itrelates to the care and use of animals inresearchExamples of, or references to, publications(e.g., journals, newsletters)A general brochure may cover some itemsrequested and is appropriate to submit.All information will be assembledand presented to the AAALAC InternationalExecutive Committee for review. Followingtheir recommendation and Board of Trusteesapproval, your organization will be notified.Signature of Executive Directoror Organizational Leader(typed name will serve as signature)Date

Membership ApplicationName of OrganizationExecutive Director or Organizational LeaderFull Name (degree/certification, if any):Mailing Address:Telephone Number:Fax Number:Email Address:Organizational Point of Contact(This individual will receive communications regarding Representative appointments, invoices, etc.)Full Name (degree/certification, if any):Title:Mailing Address:Telephone Number:Fax Number:Email Address:Individual who will serve as Representative on the AAALAC International Board of Trustees(This is a three year appointment. Representatives are expected to attend Board meetings.)Full Name (degree/certification, if any):Title:Mailing Address:Telephone Number:Fax Number:Email Address:Please send completed application and requested materials to AAALAC International via postal mail, email, or fax:5283 Corporate Drive, Suite 203 | Frederick, MD 21703 | bot@aaalac.org | tel: 301.696.9626 | fax: 301.696.9627