Please let us know if you have Questions or Comments or additional information
Second member at same address
(Membership fee is per person, not per household)
Online Membership Application
Select type of application:
Notes re PayPal:
- you do not need a PayPal account to pay this way
- the PayPal payment page will reference your "donation" but our records will clearly indicate a membership payment (it's a long story...)
($50 per person, $100 if two names entered above) Membership fee is non-refundable
($25 per person, $50 for two).
Please send Newsletter via:
NEXT of KIN information: It is important to include the name of the person who may be handling your affairs.
(you should let this person know you are listing him/her in this capacity)
Please indicate under Comments (below), the name of the chapter you are transferring from, and your member number at that chapter.
I am applying for membership for:
-- enter your own (& spouse's) name in MEMBER info.
-- enter THEIR name in MEMBER info, and your own info as next-of-kin
-- to help encourage planning for the inevitable. Enter your own contact information as NEXT of KIN or in the Questions/Comments section below. Include your email address.
Name and city of hospice, hospital, or nursing home (for at-need memberships)
Tell us how you found out about us.
Check as many as apply.