2024 AONL Affiliates - New Officer Notification Form

Affiliate and Billing Information

Please report current and newly elected officers to AONL so we can stay in contact and keep our records current. Please contact Marthe Lyngås de la Paz (formerly Forster) with any questions or concerns at mforster@aha.org or 312-422-2812.

Question Title

* 1. Affiliate Information

Affiliate Name

Number of Affiliate Members

Address

City

State

Zip Code

Phone Number

Fax Number (if applicable)

Website

Question Title

* 2. Billing Information (who should receive the invoice for affiliate dues?)

First Name

Last Name

Title

Organization

Email

Address

City

State

Zip Code

Phone Number

Fax Number (if applicable)