FY19 Individual Membership Form CLM individual membership is limited to any individual who is not employed by an organization eligible for Private Entity Membership or Public Entity Membership. Please address any questions on your eligibility for this membership to Imani Sweeney, Imani@childrensleague.org. Name First Last Primary Email* CLM will use this as the preferred email for it's external communications.Secondary EmailPrimary Phone*Mobile PhoneAddress Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code DuesCLM Individual Members must meet certain eligibility requirements. Individual dues in FY19 are $129.00.Do you prefer to receive your invoice via:*emailregular mailEmail address of person to receive CLM dues invoice: CLM's AdvocacyHow do you wish to work with CLM in the next year?Are you interested in: Serving on a Task Force Speaking with Legislators Other Thank You!Thank you for choosing to be a member of CLM. We're looking forward to working with you in advocacy for children and families in Massachusetts! We will follow up shortly with your dues invoice.