Kentucky Guardianship Association, Inc.
Print this page, complete the information and mail with check payable to Kentucky Guardianship Association to :
KGA, Inc.
P. O. Box 25173
Lexington, KY 40524-5173
Yes, I want to: ____ renew my membership or ____become a member of KGA!
____ Individual $25
____ Organization $100
____Donation (specify amount) $________
NAME ___________________________________________________
ORGANIZATION ___________________________________________
ADDRESS ________________________________________________
CITY _________________________ STATE_________ ZIP_________
PHONE __________________________________________________
FAX _____________________________________________________
EMAIL ___________________________________________________
For organization memberships please submit a list of up to five additional members with their email address.
Tell us about yourself:
____ I am a guardian for a family member or friend
____ I work in the KY public guardianship program
____ I work for a private guardianship organization
____ I work for an agency that advocates for disabled adults
____ I work for an agency that provides services for disabled adults
____ I am an attorney who represents respondents in disability cases or specializes in Elder Law
____ Other________________________________________________________
I am willing to help the association by:
___ Assisting with maintenance of website
___ Serving on a membership workgroup
___ Serving on a conference workgroup
___ Other (specify)_______________________________________