Membership

Please complete the following information:

Name: ________________________________________________________________________

Organization/Business Name:  _____________________________________________________

Address:  ______________________________________________________________________

City:  ___________________________State: ______________________Zip Code:____________

Country (if other than U.S.):__________________ Phone:  _______________________________

email:  ________________________________________________________________________

I would like to receive the quarterly newsletter via the  postal mail ________   email _________ address listed above.

Membership Categories:

• _____ Individual Membership: $35.
• _____ Family Membership: $50.
• _____ Professional Membership: $75.
• _____ Corporate/Organization Membership: $250.
• _____ International Membership: above appropriate category + $15. to cover additional mailing costs.  (example: International Individual Membership would be $35. + $15. = $50.)