Name: _________________________________________ RID Certification: ________

                                     (Please type or print in colored ink)

 

Address: _______________________________________________________________

 

City: ________________________________State: _______________ Zip: __________

 

Home Phone Number: _____________________________ Voice / TTY / Both (circle one)

 

Work Phone Number: _____________________________ Voice / TTY / Both (circle one)

 

Email Address: __________________________________________________________

q   New Membership

q   Renewal Membership Birthdate:(month & day) _________/________

Membership Category Desired: (WYRID’s fiscal year is February 1 ~ January 31)

 

q   Voting Member $25.00 ~ Individuals engaged in interpreting or transliterating, certified

                                                                            or non-certified. *Board members must have RID membership.

q   Associate Member/Non-voting $20.00 ~ Individuals who support WYRID but are

                                                                                            not actively engaged in interpreting or transliterating.

q   Student Member/Non-voting $12.50 ~ Individuals enrolled in an Interpreter

                                                                          Training Program (ITP) or an Educational Interpreter

                                                                         Certificate Program (EICP). *Must provide proof of enrollment

q   Sponsoring Member/Non-voting $25.00 Individuals or organizations with an interest

                                                                                                      in supporting WYRID’s purposes and activities.

        Pre-registration for the Fall 2002Workshop/Meeting   JJJJJJJ

*Please mail to the WYRID secretary by September 6th *Make payable to WYRID

 

        Name: _________________________________________________________________

 

        Address: _______________________________________ City:___________________

 

        State: _____________ Zip___________________ Phone: ________________________

  q     $50.00 Membership Fee

  q     $60.00 Non-membership Fee

  q     Voucher: Business or School District Name:____________________________

  q     I need an interpreter or other ADA accommodations*Must request by Sept. 6th

  q     $35.00 Discount Rate to Volunteer Interpret

        How many 20-minute blocks are you willing to interpret? _________________ (0,1,2,3,4,5, etc...)

 

        I will interpret:     Fri. p.m.         Sat. a.m         Sat. afternoon          Sat. p.m           Sun. a.m      Please circle your choice(s) 

J THANK YOU FOR VOLUNTEERING TO INTERPRET, YOU ARE APPRECIATED! J