EmailMeForm
Membership Leave Application Form
This application form will collect all of the information needed by the CASLI office to process your application for membership leave.
Please be prepared to upload any supporting documentation necessary.
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Your Name
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First
Last
Your Email Address
*
Text number
*
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What Affiliate Chapter(s) are you a member of?
ASLIA
ASLI-NB
MAPSLI
MAVLI
NAVLI
OASLI
WAVLI - If click here, please also go to https://wavli.com/reduced-membership-dues-request
In-Lieu
Select Reason Membership Leave is Required
*
Bereavement
Compassionate Reasons
Continuing Education
Maternity/Parental Leave
Medical (Illness or Injury)
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