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Membership Form
Amount
*
$225
-
Lifetime Membership
$15
-
Annual Membership - Individual
$8
-
Annual Membership - Student
Donation Schedule
One Time
Yearly
Is this a Gift Membership for Someone Else?
*
Yes
No
Member Information
Your Name
*
First Name
Last Name
Organization or Company
If you are purchasing a membership on behalf or an Organization or Company, please provide its name.
Member Email
*
If you are purchasing a membership for someone else, please provide their email address
Verify Email
*
Phone Number
Member Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Giftee's Name
*
First Name
Last Name
Your Email
*
Verify Email
*
Your Phone
Your Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Include message to giftee?
Would you'd like to include a personal message to the giftee in our member welcome email?
Yes
Message to Giftee:
Add 3% to my total amount to help cover the payment processing fees