Founder's Membership Application
To apply for membership, please complete all required questions.
Key Member
This individual is responsible for initiating membership for individuals and their families
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
I have already paid for this (these) membership(s)
*
YES
No
Not sure
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
E-mail
*
example@example.com
Cellular Number
*
Format: (000) 000-0000.
Home Number (if different from cell)
Format: (000) 000-0000.
Founder's Membership Duration
3 months
1 year
2 years
5 years
Lifetime
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Add Family Members
If the Key Member has family members seeking discounted family rates, list them here.
Family Member 1
Name
Age
Founder's Membership duration
3 months
1 year
2 years
5 years
Lifetime
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Family Member 2
Name
Age
Founder's Membership duration
3 months
1 year
2 years
5 years
Lifetime
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Family Member 3
Name
Age
Founder's Membership duration
3 months
1 year
2 years
5 years
Lifetime
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Next
Family Member 4
Name
Age
Founder's Membership duration
3 months
1 year
2 years
5 years
Lifetime
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Family Member 5
Name
Age
Founder's Membership duration
3 months
1 year
2 years
5 years
Lifetime
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Family Member 6
Name
Age
Founder's Membership duration
3 months
1 year
2 years
5 years
Lifetime
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Any questions, comments or requests?
Apply for Membership
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