By completing this form, I am consenting to and giving ILIADA/NIADA, it’s affiliates and subsidiaries, my permission to (until given written notice to discontinue) contact me and provide information to me at the mailing and e-mailing addresses, telephone and fax numbers I have provided. I certify that (I am or we are) eligible for membership in IIADA. A portion of your dues will be used for lobbying activities as defined by the Revenue Reconciliation Act of 1993. It is estimated that the percentage used for such purposes will be 22.8%. This portion of your dues is not deductible as an ordinary business expense. Contributions or gifts are not deductible as charitable contributions for federal income tax purposes.