Establish or renew a membership

You may download the Adobe Acrobat enrollment form to print/mail/email it to us or enroll online below. (To use the downloadable form, you will need to have the Adobe Reader installed. If you do not have it, you can download it for free from Adobe.)

F-48: Membership Application

Enroll Online

Please select your Membership Type and provide the information below: ( Red indicates a required field).

Annual Membership Fees are $30 per person ($15 for children under 18).
Lifetime Membership cost is $500 per person.
In addition, a one-time registration fee of $20 applies for ALL new applicants.
Your membership is for the current calendar year and is renewable annually, unless you are a Lifetime Member.

Choose a membership type:

Your Information

First Name Please fill out this field

Last Name Please fill out this field

Middle Initial Please fill out this field

Date and Place of Birth Please fill out this field

Billing Address Please fill out this field

Address (line 2) Please fill out this field

City Please fill out this field

State/Province Zip/Postal Code Please fill out this field

Country Please fill out this field

Telephone Please fill out this field

Email Address Please fill out this field

Occupation

Children under 18 (name and date of birth)

Family members who are LRFA members (name and membership number):

I prefer to receive information in: Latvian English

Your Total Membership fees: $

(Optional) would like to receive information about: Medicare Supplemental Plan Health Supplemental Plan Hospital Supplemental Plan Medical Plan For Visitors From Abroad Travel Medical Plan Final Expense Plan

(Optional) Questions and Comments:

Signature

I wish to become a member of LRFA! The above information is true to the best of my knowledge. I support the principles and work of LRFA.

Please fill out this field

Submitting Form