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Membership Form
Amount
*
$1,000
-
Wingate Circle
$365
-
Dollar-a-Day
$250
-
Steward
$100
-
Supporting
$50
-
Basic
$25
-
Student
$
Students - Please provide the name of your school and expected month/year of graduation.
Name
*
First Name
Last Name
Organization/Business
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Phone
Email
*
Verify Email
*
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