If you selected the membership fee waiver because you are an Indigenous Scholar who has a deep and personal connection to an Indigenous community of the Americas or the historically United States-affiliated Pacific and you are engaged in scholarship focused on the language(s) of that community, please attend to the box below.

Note 1: Extreme economic hardship

Extreme economic hardship includes, but is not limited to, the following:

1. Currently qualifying for food stamps, temporary assistance to needy families, unemployment benefits, Medicaid, or other federal financial assistance based on economic need.
2. Currently qualifying for a federal Pell grant or other student grant program based on economic need. Note: student loans are not grants.
3. Currently qualifying for local, state or other financial assistance programs administered by a government agency or private charity.

Note 2: Parental/Guardian Consent for Membership in LSA

NOTE: students who are under 18 years of age must also submit a signed Parental Consent Membership.

With my signature below, I affirm that the above statement is accurate and true. I understand that misrepresentations on this form may result in a loss of the waiver and other such membership privileges as appropriate.