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Membership Form
Contact Information
Amount
*
$300
-
Steward/Business II
$150
-
Patron/Business I
$75
-
Household
$50
-
Individual
$35
-
Senior/Student
Recurring Schedule
One Time
Monthly
Yearly
Membership Name(s)
*
First Name
Last Name
Organization/Employer
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Email
*
Verify Email
*
Phone
*
Membership Information
Is this a personal or business membership?
*
select one
Personal
Business
Communication Preferences
Preferred Communication Method
*
Email
Phone
Mail
Would you like to receive E-news from WCHS? (Select all that apply)
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General interest
Educator
Member
Volunteer
Do not send me E-news
Add 3% to my total amount to help cover the payment processing fees