• Current Start
  • Preview
  • Complete

Header

Student Membership Application 


Complete the required fields below and upload a copy of your valid student ID to apply for a complimentary LIA membership!


Contact Information


One file only.
350 MB limit.
Allowed types: gif, jpg, png, bmp, tif, pdf, docx, .

Contact Consent Form:
I understand that by providing my mailing address, e-mail address, and telephone number, I consent to receive communications sent by or on behalf of the Laser Institute of America (LIA). I understand that in accordance with their Privacy Statement, LIA will not share my phone, or e-mail address with a non-related third party without my prior written authorization, as expressed in the Telephone Consumer Protection Act and all subsequent revisions. Further, I understand that I can revoke this consent by contacting LIA in writing and allowing them 90 days to change my status with all subsidiaries and agents with whom they contract. I agree that my name which is included on this application affirms my consent.