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MEMBERSHIP ENROLLMENT FORM Please complete a separate form for each member Membership is per individual, not per office. Memberships at $495 and above include one or more free associates. Associate
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Fill in your full name, address, phone number, and email address.
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Indicate your date of birth and social security number.
Next, provide your membership information:
01
If you are an existing member, mention your current membership number.
02
If you are a new member, leave this section blank.
Specify your desired membership type:
01
Choose the appropriate membership level from the options provided.
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Indicate whether you want an individual or family membership.
Fill out the payment details:
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Provide your preferred method of payment (credit card, check, etc.).
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Include the necessary payment information as per the chosen method.
Complete the emergency contact and medical information:
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List the name, phone number, and relationship of your emergency contact.
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Who needs membership enrollment form-revised 4:
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Individuals interested in becoming a member of the organization.
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