Membership Application Form

Tsinat Membership Application

To apply for membership please complete all questions.
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
example@example.com
Cellular Number
Billing Adress

Use the address above.I want to specify a different billing address.
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

My Products

Basic Membership - $10 per monthAccess to member-only content on the website Monthly newsletter Invitations to member-exclusive events

$10.00 for each month

Standard Membership - $25 per month All benefits of Basic Membership Free or discounted admission to events and workshops Access to a members-only discussion forum

$25.00 for each month

Premium Membership - $50 per monthAll benefits of Standard MembershipPriority registration for events and workshopsExclusive premium member events

$50.00 for each month

Family Membership - $75 per monthAll benefits of Standard Membership for up to 4 family members Family-oriented events and activities

$75.00 for each month

Patron Membership - $100 per monthAll benefits of Premium MembershipName recognition in organization's publications or at eventsAccess to an annual VIP event or reception

$100.00 for each month

Platinum Membership - $150 per monthAll benefits of Patron Membership Complimentary guest passes for events and workshops Priority VIP seating at events Special recognition as a Platinum Member on the organization's website and at events

$150.00 for each month

Flexible Membership

USD for each month

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

Tsinat Membership Application