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Klingon Language Institute Membership Directory Form

In order to prepare the next KLI Membership Directory, we need up-to-date information from our members. The completed directory will be sent to all members along with one of the regular issues of HolQeD. The KLI does not sell its mailing list or otherwise make this information available to advertisers.

Please fill in your information below. If you need to correct your data at a later date, just fill out the form again; we will remove duplicates and keep only the most recent. Be sure to fill in both first and last names, or your data will not be recorded.

Please note: Entering your data here is not a substitute for notifying the KLI Director of a change of address for the quarterly mailings, only for the user directory.

First (Given) Name:
Last (Family) Name:
Street Address:
City:
State or Province:
Zip/Postal Code:
Country:
KLI Membership Number (from HolQeD mailing label):
Phone Number:
Email Address:

Publish this information in our Members Directory?

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