MEANT Membership Application Form

Membership Application Form

To apply for membership please complete all questions. Annual membership is valid for the calendar year (Expires on 12/31)
Membership Type*
Primary Name*

First NameMiddle NameLast Name
Spouse Name

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
E-mail*
example@example.com
Primary Number*
Home Number
Cellular Number
Qualifying Degree*
Native Place*
College of graduation*
Your Job Title*
Employer*
Special Interests
Spouse Details
Spouse Email
example@example.com
Spouse Native Place
Spouse Company
Spouse Primary Number
Spouse College of Graduation
Spouse Qualifying Degree*
Do you have a child/children?
Children's Details
Child Name1
Sex(M/F)
Grade
Age
Date of Birth
Special Interests
Child Name2
Sex(M/F)
Grade
Age
Date of Birth
Special Interests
Child Name3
Sex(M/F)
Grade
Age
Date of Birth
Special Interests
Child Name4
Sex(M/F)
Grade
Age
Date of Birth
Special Interests
Requested Membership Level*
Paypal Payment Options*
prevnext( X )
Individual Membership
$75.00



Family Membership
$125.00



Student Membership
$40.00



Life membership
$1,000.00
I hereby promise to abide by the constitution and bylaws of MEANT. I understand that the information provided above may be accessible to other members of MEANT. I promise that if I get access to similar information about other members I will not use it for unauthorized purposes. I confirm that I possess the necessary qualifications for membership as required by the current bylaws of MEANT.
Print Signature Below
Signature Date
Signature Date*

MonthDayYear
Date
Sponsoring Member Details

Detail of an existing MEANT Member who can introduce you to MEANT BoD.
Sponsoring Member Name*
Name of an existing MEANT Member who can introduce you to MEANT BoD.
Sponsoring Member Email*
Email of an existing MEANT Member who can introduce you to MEANT BoD.
Sponsoring Member Phone Number*
Phone No of an existing MEANT Member who can introduce you to MEANT BoD.
LIFE Member
2024 Membership Status
2025Membership Status
2026 Membership Status
2027 Membership Status
2028 Membership Status
2029 Membership Status
Should be Empty:

Membership Application Form

Spouse Details

Children's Details

Sponsoring Member Details