Los Angeles District (LAD)

California Dietetic Association

ONLINE Membership Application

Fields marked with an * must be filled out

* First Name
 

* Last Name
 

* Mailing
    Address
 

* City
 

* Zip
 

Home Phone
 

Business Phone
 

* E-mail
 

* Confirm Email
  Dietetic
Profession
(Food Service, Clinical, etc.)
  Business name
 

Student
/ Intern
(University)/(Internship Location)
   
  * MEMBERSHIP CATEGORY (check one)
LAD has removed late fees for our online signups!
    Active $31
Retired.   $16
Associate (student, intern).  $6 * Note: A $1 convenience charge is already added to your total membership fee to allow us to cover the charges we incur for accepting your payment online.
  Leadership opportunities
   Check the committees you would like to volunteer for.
  Research and Grants
  Professional Career Guidance
 

Continuing Education
 

Marketing
  Membership Outreach
  Speakers & Writers Bureau
  Community Relations
  Public Policy
  Fundraising
  Awards
  Assist as Needed
 

Continuing education
Check the topics you are interested in learning more about
  Nutrition in Childhood
  MNT updates & codes/Reimbursements
  Legislative Updates
  Technology in Dietetics
  Advances in Clinical Nutrition
  Alternative Diet therapies
  Advances in Sports Nutrition
  Other Suggestions
  Check here if you do not wish to be listed in the LAD Member Roster

LAD will not store your payment card. If you have a Paypal account, please note: Paypal will not ask you for your username and password through email or over the phone.
Your information is transmitted through Paypal's server and not LAD's so you can feel confident your information is transmitted securely.