First Name: 

Last Name: 

Business Name (if you have one): 

Address (line 1): 

Address (line 2, optional): 

City: 

State: 

Zip:   

Daytime (Work) Phone:    -     -    

Evening (Home) Phone:    -     -    

E-mail (which will be used to activate your announce and discuss email list membership):

Please select your payment method:

Note: membership benefits, including discuss email list, do not start until payment received; use PayPal option if you want to activate sooner.

I would like to use PayPal to pay with Credit Card or Check on-line  (Note: You do not need to have a PayPal account to use this service.  Once you get to PayPal there is an area on the webpage to enter that you want to pay by credit card or check.  You should be able to find a link that says 'continue' right above some credit card icons that you can click.)

I will bring my application and payment to the next meeting

I will mail in my application and payment (address will appear after 'submit')