Membership & Donation Form

Online Membership & Donation Form
Full Name*

First NameLast Name
Business Name Type a label
E-mail*
example@example.com
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Membership Options

Individual: $35 add $15 for MSA

Family: $50 add $15 for MSA

Business: $100 includes MSA

Calendar Raffle

Calendars are $10 each and will be drawn every day in March.

Please enter the total for your membership, donation and/or calendars in the box below and what you are paying for in the comments.
Comments
You will be directed to PayPal in a few seconds after clicking "Submit", please complete all required information in PayPal.
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Payment Methods

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Online Membership & Donation Form