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<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=90 BGCOLOR="#006699" TEXT="#080000" background="055785a3.jpg"> <div> <FONT SIZE="3" COLOR="#FFFFFF" FACE="Arial" ><B>Cleveland-NEO AALNC CHAPTER</B><B> </B></FONT><B>   </B><B> |     </B><A HREF="index.htm" TARGET="_top" TITLE="ClevelandNEO AALNC CHAPTER"><U><B>home</B></U></A></div> <div> <A HREF="id17.htm" TARGET="_top" TITLE="Board of Directors "><U>Board of Directors </U></A>   |   <A HREF="id18.htm" TARGET="_top" TITLE="Committee Chairs "><U>Committee Chairs </U></A>   |   <A HREF="id19.htm" TARGET="_top" TITLE="Presidents Message"><U>President's Message</U></A>   |   <A HREF="id101.htm" TARGET="_top" TITLE="Membership Renewal"><U>Membership Renewal</U></A>   |   <A HREF="id100.htm" TARGET="_top" TITLE="National AALNC News"><U>National AALNC News</U></A>   |   <A HREF="id20.htm" TARGET="_top" TITLE="Meeting Dates"><U>Meeting Dates</U></A>   |   <A HREF="id23.htm" TARGET="_top" TITLE="Members"><U>Members</U></A>   |   <A HREF="id95.htm" TARGET="_top" TITLE="Members by Specialty"><U>Members by Specialty</U></A>   |   <A HREF="id96.htm" TARGET="_top" TITLE="Experts by Specialty"><U>Experts by Specialty</U></A>   |   <A HREF="id63.htm" TARGET="_top" TITLE="Member Biographies"><U>Member Biographies</U></A>   |   <A HREF="id24.htm" TARGET="_top" TITLE="Related Links"><U>Related Links</U></A>   |   Join Our Chapter   |   <A HREF="id26.htm" TARGET="_top" TITLE="Members Access "><U>Members Access </U></A>   |   <A HREF="id99.htm" TARGET="_top" TITLE="Disclaimer"><U>Disclaimer</U></A></div> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#FFCC66" TEXT="#080000" background="056d2b03.jpg"> <bR> <div> Cleveland-NEO AALNC</div> <div> Chapter</div> </td> <td valign="top" height=390 BGCOLOR="#99CCFF" TEXT="#080000"> <div> <B><U>Join Our Chapter</U></B><B><U> <A NAME="chapter"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B></div> <div> To join our chapter or renew your membership please fill in the following form. </div> <div> You must be a national AALNC member to belong and your membership number must be included for us to process your application. If you are not a national member and would like to apply, click on this link: <FONT SIZE="4" COLOR="#0000FF" FACE="Arial" ><A HREF="http://www.aalnc.org/images/pdfs/MembershipApp.pdf" TARGET="_top" TITLE="http://www.aalnc.org/images/pdfs/Members"><U>aalnc.org/images/pdfs/MembershipApp.pdf</U></A></FONT></div> <div> Space has been provided for 3 licenses. If you are licensed in more than 3 states please provide additional license information in a seperate e-mail to the address below. Please attach the information or your biography to be included in the yearly directory.</div> <div> Our yearly membership fee is $100.00 for independent LNC's and $75.00 for in-house, law firms LNC's, and student LNC's. You will be notified by e-mail of the status of your application. Please make checks out to Cleveland NEO AALNC and mail to:</div> <div> Linda Gartman</div> <div> PO Box 209</div> <div> Avon, Ohio 44011-0209</div> <bR> <div> Questions and inquiries should be submitted to: NICKIRN@aol.com</div> <bR> <div>  <form action="http://csbmail.globalscape.com/cgi-bin/csbmail/csbmail.pl" method="POST" enctype="application/x-www-form-urlencoded"><input type="hidden" name="tlx_SortOrder" value="Name,Credentials,Street Address,City,State,Zip Code,Phone Number,Extension,Fax Number,E-mail Address,Name of Business/Employer,License,License,License,AALNC MEMBERSHIP NUMBER (Necessary for local chapter membership),New Member (Place X),Renewel (Place X),Date,Information you want published on the website.,I certify that the above information is true and accurate."><input type="hidden" name="tlx_FormIndex" value="1"><input type="hidden" name="tlx_OKMessage" value="Thank you for your interest in our chapter. We will process your application and get back to you soon."><input type="hidden" name="tlx_SendMode" value="1"><input type="hidden" name="tlx_Subject" value="An application was submitted"><input type="hidden" name="tlx_EmailTo" value="lnc@kmrlegalnurseconsultants.org"> <table cellpadding="0" cellspacing="1" border="0" align="center"> <tr> <td align="left">Name: (Last, First, M.I.):<br> <input type="text" name="Name" size="50" maxlength="50"></td> </tr> <tr> <td align="left">Credentials:<br> <input type="text" name="Credentials" size="50" maxlength="50"></td> </tr> <tr> <td align="left">Street Address:<br> <input type="text" name="Street Address" size="50" maxlength="50"></td> </tr> <tr> <td align="left">City:<br> <input type="text" name="City" size="30" maxlength="30"></td> </tr> <tr> <td align="left">State:<br> <input type="text" name="State" size="30" maxlength="30"></td> </tr> <tr> <td align="left">Zip Code:<br> <input type="text" name="Zip Code" size="10" maxlength="10"></td> </tr> <tr> <td align="left">Phone Number (Area code+number):<br> <input type="text" name="Phone Number" size="14" maxlength="14"></td> </tr> <tr> <td align="left">Extension:<br> <input type="text" name="Extension" size="6" maxlength="6"></td> </tr> <tr> <td align="left">Fax Number (Area code+number):<br> <input type="text" name="Fax Number" size="14" maxlength="14"></td> </tr> <tr> <td align="left">E-mail Address:<br> <input type="text" name="E-mail Address" size="50" maxlength="50"></td> </tr> <tr> <td align="left">Name of Business/Employer:<br> <input type="text" name="Name of Business/Employer" size="30" maxlength="100"></td> </tr> <tr> <td align="left">License (number, state, expiration date) :<br> <input type="text" name="License" size="50" maxlength="50"></td> </tr> <tr> <td align="left">License (number, state, expiration date):<br> <input type="text" name="License" size="50" maxlength="50"></td> </tr> <tr> <td align="left">License (number, state, expiration date):<br> <input type="text" name="License" size="50" maxlength="50"></td> </tr> <tr> <td align="left">AALNC MEMBERSHIP NUMBER; (Necessary for local chapter membership):<br> <input type="text" name="AALNC MEMBERSHIP NUMBER (Necessary for local chapter membership)" size="30" maxlength="30"></td> </tr> <tr> <td align="left">New Member (Place X):<br> <input type="text" name="New Member (Place X)" size="1" maxlength="1"></td> </tr> <tr> <td align="left">Renewel (Place X):<br> <input type="text" name="Renewel (Place X)" size="1" maxlength="1"></td> </tr> <tr> <td align="left">Date:<br> <input type="text" name="Date" size="8" maxlength="8"></td> </tr> <tr> <td align="left">Information you want published on the website.:<br> <textarea name="Information you want published on the website." rows="10" cols="50"></textarea></td> </tr> <tr> <td align="left">I certify that the above information is true and accurate. (Place X):<br> <input type="text" name="I certify that the above information is true and accurate." size="1" maxlength="1"></td> </tr> <tr> <td align="right"><input type="reset"> <input type="submit" value="Send" name="tlx_send"></td> </tr> </table> </form>  </div> </td> </tr></table></body>