2023 IWC Membership Renewal

2023 IWC Membership Renewal
Final deadline for renewal is January 31, 2023

After that date, membership will lapse and reapplication will be necessary!
OWNER INFORMATION
First Name*
Last Name*
~ Please fill out the following contact information section

only if there are changes.~
Address

Street Address

Street Address Line 2

CityState / Province (Use 2 letter abbreviation ALL CAPS)

Postal / Zip Code Country
Preferred Phone Number

Area CodePhone Number
Other Phone Number

Area CodePhone Number
Email
example@example.com
Additional Names for Family Membership. Please list names, ages, and emails .
Note: Members with an email address will receive club communications via e-mail. Please make sure we have your current email.
Membership Type (please also fill in renewal fee in box below!)*

Individual 1 year $20Bird Individual 3 year $54Family 1 year $30Family 3 year $81Junior 1 year $10
Renewal Fee $*
Donation to the Windsprite Genetic Diversity Project/IWC Health/Rescue Fund (Optional)
Optional
Total Payment Due $
(automatically calculated)
Preferred Payment:*

Payment via PayPal (Fill in amount due in "Total PayPal Payment" field below, and click on desired PayPal Button.)Mail check or money order (Please make payable to "IWC" in US$and mail to: IWC c/o Sidney Hoblit, 33 Pine Grove Rd, Nottingham PA 19362.) DO NOT FILL IN THE "TOTAL PAYPAL PAYMENT"' FIELD BELOW IF YOU ARE NOT PAYING WITH PAYPAL!Payment via Venmo. Send to @International-WindspriteClub
TOTAL PAYPAL PAYMENT

prevnext( X )
USDLeave blank if not paying with paypal

loading smart payment buttons...

The payment is ready! It will be completed once you submit the form.
E-Signature (Parent/Guardian if < 18 years of age)*
Typed signature constitutes a valid electronic signature
If you have any questions or problems with filling out the form, contact Sidney Hoblit LHWLady@gmail.com
Should be Empty: